A 40 y/o lady with history of valve surgery is admitted to hospital because of left hemiparesis, she only took warfarin as her medication & her last INR was about 2.2. Echocardiography is shown.

According to the echocardiography, what is your plan for patient ?

The 33-year-old man, with a previous medical history of thymic lymphoma and having undergone chemotherapy two years ago, showed no detectable malignancy in a PET scan one year ago. His recent presentation to the emergency room complaining of dyspnea prompted further investigation. Notably, physical examination revealed a muffled heart sound and prominence of the jugular venous pressure (JVP). Subsequent echocardiography indicated the presence of massive pericardial effusion accompanied by a swinging heart.

In the management of this condition, pericardial fluid was drained from the patient. Regarding the analysis performed on the drained fluid, which of the following options is incorrect?

Pericardial Fluid:

- Cholesterol: 107 mg/dL

- Triglycerides (TG): 1027 mg/dL

- Lactate Dehydrogenase (LDH): 140 U/L

Serum:

- LDH: 154 U/L

- Cholesterol: 120 mg/dL

A 44-years-old man with no past medical history was referred to ED due to general weakness and abnormal ECG findings (Figure 1). He did not take any medication. On physical examination, deformity of the extremities was evident (Figure 2). A brain CT was done due to suspicion of intracranial hemorrhage showing severe basal ganglia calcification (Figure 3).

What causes ECG changes?

A 35 years old man with palpitations and low LVEF=40%, ECG and Holter tracings are shown:

What is your diagnosis and treatment plan?

A  40 y/o man underwent catheterization because of occasional dyspnea.

According to video of his catheterization ,can you name the anatomic location marked with *?

A 58-year-old lady with ICD_VR who presented with diaphragmatic twitching from 4 days ago. In the surface ECG, no capture is seen during the diaphragmatic twitching, but at the same time analysis of the device, the V pace is seen at a rate of 45 beats/min. The lead impedance was also 380 ohms, which has droped by about 250 ohms in the last 4 days. It denies any palpitation, chest pain, dyspnea and ICD shock. What is the most probable diagnosis for this patient?

What is the diagnosis?

A young man experiencing palpitations and presyncope in the ER was treated with Procainamide. See his ECGs below:

Which statement about his EP procedure is TRUE?

A 32-year-old patient with palpitations underwent EPS and ablation, below ECG during arrhythmia is shown:

What diagnosis is less possible?

A young girl with palpitations underwent EPS, below you can find the tracing of arrhythmia.

which kind of arrhythmia is NOT probable?

Below you can find 3D mapping and EP signals of a case of VT ablation: 

What statement is wrong in this case?

A 35 y/o woman underwent Echocardiography for evaluation of holosystolic Murmur.

What is your most liklely diagnosis?

35 y/o man underwent echocardiography for evaluation of nocturnal chest pain. Echocardiography is shown:

Based on the echocardiography, which one is NOT seen in this patient?

92 y/o frail man presented with unexplained syncope when sitting and also in supine position. LVEF=50%

ECG is shown.

What is your plan for the patient?

A middle-aged man with frequent PVC and Low LVEF, below you can find EP tracing during PVCs and also ablation.

What statement is wrong?

A 50 y/o female patient admitted with atypical chest pain.

ECG is shown:

The ECG findings are most consistent with which ONE of the following diagnoses?

A 70 years old man with a history of hypothyroidism and CHF came to the clinic without any complaints.
3 years ago, An ICD DR was implanted for him.
He takes these drugs:
Amiodarone 200mg BD, ASA 80mg Daily, Pantoprazole 40 mg Daily, Losartan 25 mg Daily, spironolactone 25mg Daily;

According to the shown ECG, which action is more correct?

27 years old girl underwent EPS for palpitation. An EP tracing during EPS is shown.

Which statement is TRUE about this tracing?

A 45 years old electrician with a history of ICD implantation, experienced ICD shock. Below you can find plot diagram and EGM of the event. 

which statement is WRONG?

A young lady came with palpitations, she had a previous session of RF ablation 6 years ago for WPW. ECG is shown.

According to the ECG, what is the diagnosis?

A 68 years old lady underwent CRT-D implantation. Biventricular pacing is could not be achieved after implantation Fluoroscopy and chest X-Ray of the patient are given. ECG after implant also given:

What is wrong with the device?