An 82-year-old lady came to the ER with the chief complaint of palpitation, she denied any complaints of dyspnea and chest pain, and her past medical history was remarkable for Dual chamber pacemaker implantation 6 months ago due to complete AV block.

what is the best next step ?

33 years old man underwent cardiac surgery 4 days ago. ICU head nurse called me to visit the patient for mild dyspnea. CXR was ordered. 

What do you think about the baseline pathology? what other abnormality do you see? 

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? 

a 40 y/o man with a history of hybrid TEVAR operation underwent CT angiography for routine follow up:

CT angiography is shown:

In CT angiography there is an incidental congenital heart defect, can you guess what defect is shown?

A  53 y/o man underwent echocardiography for evaluation of chronic dyspnea on exertion & edema.

Which statement is true about the patient?

A 21-year-old man suffered a cardiac arrest during physical activity. Cardiopulmonary resuscitation (CPR) was performed for a duration of twenty minutes, and the patient was subsequently transported to the hospital. According to the EMS personnel, the patient had a VT rhythm during cardiac resuscitation, as indicated by the electrocardiogram and echocardiography.

 Which option is incorrect?

A 54 years old man with Preexcitation.ECG is shown:

Where is accessory pathway?

A middle-aged man with frequent PVC, LVEF=35%,  and previous unsuccessful ablation in another center underwent RF ablation with the guide of Precision.

Where is the source of origin of PVC?

A 65 y/o man with history of MVR 2 years ago come to ED complaining of new onset dyspnea from 3 days ago.

Which statement is TRUE about the patient?

A 49-year-old woman with palpitations and frequent PVCs on surface ECG and Holter monitoring (PVCs burden: 15%), referred for ablation.

The surface ECG is shown below.

Which statement about this PVC type is correct?

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?

A 80 years old woman came to ED with Dizziness and Nausea.

Past Medical Hx : DM,HTN,CKD,CVA

ECG is shown:

What is your best diagnosis and treatment for this case ?

A 75 y/o lady underwent echocardiography for evaluation of dyspnea. Echocardiography is shown:

Which statement is TRUE about the patient?

A young patient underwent EPS for paroxysmal SVT, Parahisian Pacing maneuver is shown:

According to the result of this maneuver, what is the most probable Arrhythmia?

A 25-year-old patient came to our clinic with the chief complaint of palpitation, based on his surface ECG, we scheduled him for EPS.

According to his surface ECG and EP tracing, which statement is not true?

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 middle-aged patient underwent EPS and Ablation for incessant arrhythmia, below you can find 12 lead ECG and EP tracings of the patient.

What is the most probable arrhythmia? 

Below you can find the EP tracing of a patient with narrow complex tachycardia.

Which one is not present in the tracing?

A middle-aged lady came with palpitations, three ECGs are shown below:

What is your diagnosis?

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

What is your most liklely diagnosis?