Case #780-Ali Bozorgi

History:

A man in his 70s presented with frequent premature ventricular complexes (PVCs) and a reduced left ventricular ejection fraction (LVEF). The morphology of his PVCs is shown below.

Question:

What is the origin of PVC?

Case #626-Ali Bozorgi

History:

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

Question:

Which statement about his EP procedure is TRUE?

History:

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.

Question:

 Which option is incorrect?

Case #648-Shayan Shahi

History:

A 43-year-old  gentleman with a known case of Apical HCM underwent 48-h ECG holter monitoring for SCD risk stratification.

Below is one shot from his ECG Holter Monitoring :

Question:

Which one is the best next step?

Case #505-AliReza Farzaei

History:

A female patient aged 53 years, with a medical history of aortic valve replacement (AVR), mitral valve replacement (MVR), and tricuspid valve repair (TVr) five years ago, presented at the medical facility without any symptoms but with a prolonged withdrawal from warfarin for several months. The patient was admitted, and heparin therapy was initiated along with a transthoracic Doppler echocardiography (TDI TTE) examination and fluoroscopy. 

Question:

Based on the results obtained from the TDI TTE and flouroscopy what do you consider the most appropriate course of action?

Case #645-Shayan Shahi

History:

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.

Question:

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

Case #732-Ali Bozorgi

History:

A young woman underwent an electrophysiology (EP) study. Interpret the tracing below.

Question:

What is WRONG about this tracing:

Case #366-Ali Bozorgi

History:

A 17-year-old girl with palpitations underwent EPS, Two tracings of basic ECG and arrhythmia are shown.

Question:

What is the etiology of arrhythmia?

Case #720-Siroos Nasiri

History:

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

Question:

Where is the most likely location of the accessory pathway? 

Case #782-Ali Bozorgi

History:

A patient with frequent palpitations underwent EPS you can see the EP tracing below:

Question:

What is the most probable diagnosis?

History:

A 30 y/o woman underwent echocardiography for evaluation of dyspnea. She claimed that her dyspnea worsens while lying on the left side.

Question:

What is the most likely diagnosis?

Case #466-Ali Bozorgi

History:

A 30-year-old patient was admitted to the hospital because of syncope, at 3 AM he woke up complaining of palpitations, based on the rhythm strip, the on-duty resident started Lidocaine. 

Question:

What would be your advice for him/her?

Case #230-Hamid Khederloo

History:

A 72_years_old female is referred to ED with epigastric pain, nausea and vomiting, confusion, general weakness, and blurred vision. She does not know her past medical history and the medication she takes.

ECG is shown:

 

Question:

What is your next preferred step for this patient?



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 #196-Sarah Taaghi

History:

A 43 years old gentleman with no remarkable past medical history, presented to the Emergency department with progressive weakness from 7 days ago.
He didn’t recall any pain or any other symptoms.


During first evaluations , his SBP was 250mmHg and his serum creatinine was 7 mg/dl. Based on his Chest X-ray, we performed echocardiography and CT angiography.


Below you can find CXR , CTA and echocardiogram.

Question:

What is your plan?

Case #494-Ali Bozorgi

History:

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

Question:

What is the most probable diagnosis?

Case #121-Ali Bozorgi

History:

A 58 years old man with several episodes of syncope once in supine position. Baseline ECG showed RBBB and LAHB (bifascicular block). LVEF=55%, EPS done. EP tracing is shown:

Question:

What is the tracing interpretation and next plan?

Case #76-Ali Bozorgi

History:

A 31 years old man was admitted to hospital with Non-STEMI. He had no known coronary artery disease (CAD) risk factors, but had a history of prolonged unexplained febrile disease when he was five years old. Coronary angiography performed. Two shots are given below.

Question:

What is the most likely etiology?

Case #634-Ali Bozorgi

History:

Below is the 12-lead ECG of a patient who underwent EPS. Prior to this tracing, we were attempting to capture the "His" signal."

 

Question:

Which statement is wrong?

History:

50 Y/O female presented to hospital complaining about recent exertional chest pain and episodes of syncope which mostly happened at the time of doing home laundry.

 

 

Question:

According to this aortography, Which one is the most probable cause of syncope in this patient?

In Loving Memory of

Dr. Maryam Khoshnevis

MD, Cardiologist

Fellowship of Echocardiography

Faculty member of TUMS

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