50 y/o man underwent echocardiography for evaluation of orthopnea .
Trans-thoracic Echocardiography is shown.
which one is NOT seen in this echocardiography?
An 80 years old man with history of Chronic Kidney Disease and Heart Failure, came to ED with weakness, loss of appetite, nausea.Recently Spironolactone and Valsartan added to his medications. ECG is shown.
What is your diagnosis?
A 50-year-old man with a history of high blood pressure and diabetes complained of severe chest pain. Initial tests revealed a positive troponin result.
Based on the EKG and echocardiogram findings, what is the most likely diagnosis?
A woman in her 20s presented to the EP lab with wide complex tachycardia. Below is the 12-lead ECG.
What is the most probable diagnosis?
A young lady with palpitations. ECG of the arrhythmia is presented below.
Which diagnosis is NOT probable?
A 39-year-old man with history of DCM and reduced LVEF (25%), presented with palpitations and frequent PVC on surface ECG and Holter monitoring (PVC Burden: 40%), referred for ablation. EPS was done by 3D NAVX/Precision mapping guide. Initially, Based on surface ECG which was compatible with LV summit origin, mapping was started within CS, the best earliest signal was found in GCV (-42ms). RF applied on aforementioned area, but PVCs did not disappear. So, mapping was done via retrograde trans-aortic approach. After maintaining safe distance from LM,LCX and LAD by coronary angiography and considering correspondent point from epicardial mapping, the best earliest point was found around ILT area (-44ms). RF applied on aforementioned area and PVCs disappeared immediately.
Four fluoroscopic views and surface ECG are shown.
Which of the fluoroscopic views is in favor of catheter ablation position in the ILT (Inter Leaflet Triangle)?
A 50 y/o man underwent echocardiography for assessment of heart murmur.
What is your most likely diagnosis?
A middle-aged patient underwent EPS for palpitations, EP tracings are shown below:
What is the etiology of the arrhythmia?
A 24-year-old man arrived at the emergency department complaining of pleuritic chest pain that commenced shortly after the initiation of playing tennis.
The patient's vital signs were documented as:
Blood pressure: 100/50 mmHg
Heart rate: 105 beats per minute
Respiratory rate: 18 breaths per minute
Temperature: 36.5°C
Those are the initial ECG that was taken 10 minutes after arrival:
What is the best next management strategy?
23 year-old male with a “variable pulse rate" .ECG was shown:
What is the rhythm?
A 52-year-old lady with frequent palpitations, below you can find the ECG and EP tracing.
What is the most likely diagnosis?
A 68-year-old woman with the past medical history of aortic valve replacement (AVR), mitral valve replacement (MVR), and septal myectomy (2013), presents to the emergency department. She reports a two-day history of substernal heaviness. The onset of her symptoms coincided with a interpersonal conflict involving her daughter and son-in-law.
Her prior coronary angiography, performed at the time of her valve surgery, was reported as normal.
Based on the most probable diagnosis suggested by the ECG and echocardiography findings, which of the following choices is correct?
An angiogram of the right coronary artery is shown with concomitant 12 lead ECG.
What happened and why?
22 y/o girl referred to EP clinic with LVEF=30% with global HK and "arrhythmia"
Two ECG is shown.
What is the most likely diagnosis?
A 52 y/o man underwent echocardiography for evaluation of dyspnea on exertion .
Based on echocardiography could you guess the mechanism of severe MR?
A 21 years old girl with frequent palpitations, both ECG and Holter are shown:
What is the diagnosis? Which complication should be considered with RF ablation ?
A 52-year-old gentleman reffered for EP study, due to episodic palpitations and wide complex tachycardia requiring cardioversion in ER.
During EPS, the HV interval was 90 msec, and arrhythmia was induced with burst pacing.
Below you can find 12-lead ECG (during tachycardia, sinus rhythm ) and EP tracings.
What is the most probable diagnosis?
A 42-year-old patient, with palpitations, ECG of both arrhythmia and resting are shown
Regarding ECG what is the most probable cause of arrhythmia?
A young patient with narrow complex tachycardia underwent EPS, An EP tracing is shown below.
What is NOT seen in EP tracing?
An 18-year-old girl presented to the emergency room with a syncope episode while seated, lasting 20 seconds.
Considering the echocardiography and electrocardiogram (ECG) findings, which diagnosis is unlikely?
In Loving Memory of
Dr. Maryam Khoshnevis
MD, Cardiologist
Fellowship of Echocardiography
Faculty member of TUMS