Case #335-Ali Bozorgi

History:

A middle-aged lady with wide complex tachycardia underwent EPS. ECG of Arrhythmia and an EP tracing of high RA pacing are shown below:

Question:

What is the most probable diagnosis?

Case #682-Aghil Zarbini

History:

A 56-year-old man with no known cardiac risk factors presented to our clinic for further evaluation following survival from sudden cardiac arrest (SCA) one week prior at an outside facility. The patient denied any cardiac symptoms, including chest pain or dyspnea. Vital signs were stable at presentation. ECG did not lead to any specific pathology. Echocardiography is shown

Question:

Which statement is false?

Case #191-Sarah Taaghi

History:

46 years old lady, presented to the ER with chief complaint of sudden weakness , low blood pressure and presyncope. 
 She was diagnosed with hypertension from 5 years ago and was on Losartan 25 mg BID from then. 
In the ER her BP was 90/66 mmHg and she claimed  receiving 1000 ml Normal saline in a clinic before referring to the ER, and her SBP was 70 mmHg the time.
She denied overusing her medication and any other symptoms.
Below you can find ECG and echocardiogram.

Question:

what is your next step?

Case #652-Ali Bozorgi

History:

Below is a video showcasing an episode of tachyarrhythmia recorded by an ICD in a middle-aged man.

Question:

What statement is WRONG about this tachycardia episode?

Case #523-Ali Bozorgi

History:

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. 

Question:

which statement is WRONG?

Case #330-Ali Bozorgi

History:

A middle-aged lady underwent EPS with 3D mapping, below you can see the 3D mapping of her arrhythmia :

Question:

Based on the 3D mapping, what is the possible arrhythmia?

Case #666-Ali Bozorgi

History:

A middle-aged man with MVR, EPS performed, Below are the findings: ECG during arrhythmia, EP tracings, fluoroscopic imaging, and sinus rhythm ECG.

Question:

What is the best explanation?

History:

A 68 y/o woman (wt=62 kg) came to the hospital with a chief complaint of palpitations and chest pain. Two weeks earlier, she underwent PCI procedure due to STEMI and she was receiving ASA 80 mg daily and Ticagrelor 90 mg BID. In laboratory findings, SrCr was 2.1 mg/dL and her ECG revealed atrial fibrillation. 

Question:

What is the most appropriate antithrombotic regimen for this patient during the first year after PCI?

History:

A 40-year-old man complained of shortness of breath and orthopnea during the last week. He had no usual cardiovascular risk factors, no history of medication, supplement, or drug use, and no history of recent viral infection.

The patient's appearance is significantly different from other family members (e.g. he is taller than his brothers.)

In the electrocardiogram, sinus tachycardia was seen.

In the echocardiography, EF=20% was reported and there was no evidence of LVH.

In the coronary angiography, there were no coronary lesions.

Question:

Based on his physical appearance, Which finding of the patient seems incorrect?

Case #540-Ali Bozorgi

History:

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

Question:

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

Case #604-Ali Bozorgi

History:

A 49-year-old physician experiencing frequent palpitations and having undergone an unsuccessful ablation in another hospital. The arrhythmia tracing, programmed RV stimulation, and LV pacing are provided below.

Question:

Which statement is TRUE?

Case #669-Aghil Zarbini

History:

A 78 year old lady with history of diabetes mellitus, hypertension, heart failure (ejection fraction about 30 percent), COPD and no documented history of arrhythmia has been admitted due to combined COPD exacerbation and decompensated heart failure. baseline ECG is shown below. after 3 days of admission she experienced palpitation and ECG during palpitation is also shown.

Question:

What is the most correct diagnosis and management?

Case #381-Ali Bozorgi

History:

A middle-aged patient came to ED for an ICD shock. The tracing of shock delivery is shown:

Question:

what is your interpretation?

Case #661-Sarah Taaghi

History:

A 35-year-old man was referred for an electrophysiology study due to multiple episodes of PSVTs. During EPS arrhythmia was easily induced, which you can find below as tracing A. After localizing the best signal, with RF application the retrograde activation of arrhythmia changed (tracing B).

Question:

According to tracing A and B, which statement is correct?

Case #372-Ali Bozorgi

History:

A middle-aged man underwent a coronary angiogram, below you can find angiography and concomitant 12 lead ECG:

Question:

What is your diagnosis?

History:

A 61-y/o patient with a history of atrial fibrillation and 3VD is candidated for CABG. He was receiving rivaroxaban 20 mg daily at the time of admission.

Question:

What is your suggestion for perioperative management of his antithrombotic regimen?

Case #521-Samane Mohamadi

History:

A 60 years old male with pmh of CRT-D implantation last year,presented with this ECG. he had episodes of dizziness.
the ECG and CXR are shown below.

Question:

Which statement is correct?

Case #590-Ali Bozorgi

History:

A 70-year-old woman experiencing dizziness; below are the ECGs captured over the course of one day.

Question:

Which option is NOT as accurate in this scenario?

Case #54-Ali Bozorgi

History:

A 52 y/o lady with recent dual chamber pacemaker implantation presented by dizziness.

ECG and Chest XRay are shown.

PPM analysis showed Normal RA and RV impedance, Normal Atrial lead sense and pacing, no RV capture.

Question:

What is the etiology of device malfunction?

Case #333-Ali Bozorgi

History:

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:

Question:

What is wrong with the device?

In Loving Memory of

Dr. Maryam Khoshnevis

MD, Cardiologist

Fellowship of Echocardiography

Faculty member of TUMS

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