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 38 years old woman with history of valve replacement surgery (7 months ago) came to ER with DOE FC II from 3 weeks ago. Admission INR was 2.4.

She underwent fluoroscopy to evaluate the valve function. 

Her vital signs were unremarkable. 

What is the diagnosis and more suitable treatment strategy? 

A 30 y/o man underwent catheterization for evaluation of congenital heart disease.

One shot of catheterization is shown:

Can you guess the catheterization course?

A 75 years old man came to the clinic with a complaint of dyspnea on exertion, ECG is shown below:

Based on ECG what would be expected in echocardiography?

An 80 year old asymptomatic lady came with below ECG:

What is your diagnosis?

A 72‑year‑old woman with a history of type 2 diabetes mellitus, ischemic heart disease, and end-stage renal disease on routine hemodialysis presents to the emergency department with malaise, generalized weakness, and nausea since last night.

On arrival:

• Blood pressure: 100/60 mmHg

• Pulse: 26 bpm, regular

• She appears fatigued but arousable.

Her ECG is provided.

What is the most appropriate immediate next step in management?

A electrocardiogram (ECG) of a young boy is shown below:

What is an appropriate statement to describe premature ventricular contractions (PVCs)?

A 56-year-old man with palpitations and manifest preexcitation on surface ECG, referred for ablation.
ECGs  before and after full preexcitation are shown.

Where is the most likely location of the accessory pathway? 

This ECG is taken during the ablation of case no.459, divided by a blue bar into two segments.

There are subtle changes in ECG, what is your diagnosis?

A 56 years old male patient with palpitations and frequent PVCs on surface ECG with PVCs burden of 40% on Holter monitoring , referred for ablation. Below you can find the  surface electrocardiogram.

Based on the surface ECG , what is the most possible localization for PVCs.

A woman aged 30, with a known history of dilated cardiomyopathy (left ventricular ejection fraction, LVEF, at 15%), reported experiencing palpitations. Subsequently, three electrocardiograms (ECGs) were conducted and are presented below:

What types of arrhythmias are currently evident?

A young lady with palpitation underwent EPS and ablation. Surface resting ECG is shown.

What is the most probable diagnosis of the patient's arrhythmia?

A young boy with frequent palpitations, below you can find EP tracing of arrhythmia and also post-pacing interval.

What is the most probable diagnosis?

A 78-year-old man with a history of congenital heart block and PPM implantation presented to the ER with dizziness from 3 days ago. Here you can see his ECG: 

What's your plan to alleviate patient's symptoms?

70 y/o man with history of CABG underwent coronary angiography for evaluation of exertional chest pain .

which statement is TRUE about the patient?

A 35 years old asymptomatic man was referred for evaluation of ECG, two ECGs are shown, the first one was captured during covid when he was febrile the other is today's ECG.

What are you going to do?

A 63 years old man with normal LVEF and history of palpitations and dizzi spells, underwent EP study.

ECG and EP tracing are shown :

According to EPS what is your diagnosis and next step of treatment?

A middle-aged patient with no structural heart disease came to ED with syncope. ECG is shown.

Based on 12 lead ECG what are your diagnosis and plan?

70 years old man with a history of ICD implantation, was admitted for ICD shock. Below you can find the tracings of the patient.

What statement is wrong?

A 32-year-old male presents to the cardiology clinic with a history of palpitations and syncope. He reports that he has been experiencing these symptoms for the past six months, and they have been increasing in frequency and severity. He denies any chest pain or shortness of breath.

A transthoracic echocardiogram (TTE) reveals mild dilatation of the right ventricle (RV) with reduced RV function and an ejection fraction of 40%. The left ventricle (LV) is normal in size and function.

The EKG is shown.

Based on the diagnosis, which one is correct?