A 70 years old man underwent biologic aortic valve replacement 3 days ago. He had history of GI bleeding last year. Coronary angiogram showed mild CAD. His rhythm is normal sinus and vital signs are unremarkable. 

According to the latest guidelines which anticoagulant and/or antiplatelet therapy do you suggest after discharge?  

Case: Middle-aged lady with palpitations and previous failed ablation at another center. ECGs below. (rest and tachycardia)

What is the most probable diagnosis?

An 82-year-old man with a history of TAVR and PPM-DR insertion due to transient AV Block after TAVR has presented for device analysis with this ECG without any symptoms.

What's your interpretation?

Sad day at the emergency department unit!

18 y/o girl came to ED complaining of worsening dyspnea since two weeks ago. She claimed that she could not sleep at all because of dyspnea. In her medical records, according to chronic cough, she was recently underwent a biopsy of the lymph node in her mediastinum, and the results showed lymphoproliferative disorder.

Her vital sign: HR=140 beat/min  BP=90/60   O2saturation=93 %    RR=30

An ECG & echocardiography was done immediately.

which statement is NOT true about the patient?

A 38-year-old with palpitation.ECG during palpitation is shown:

What is the most probable diagnosis?

Below you can find the angiogram of a patient.

What would you not expect to find in an echocardiogram?

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 57-year-old gentleman with a history of NICMP ( EF:20%) underwent ICD implantation three years ago due to episodes of VT and came to our ED with a chief complaint of multiple episodes of ICD Shock.

Below are four shots of his arrhythmia episode:

What is the diagnosis?

A 65-year-old male presents to the emergency department with shortness of breath and fatigue that has been worsening over the past few months. He has a past medical history significant for hypertension and hyperlipidemia, for which he is on medications. The patient denies any chest pain or palpitations. On physical examination, his blood pressure is 140/90 mmHg, heart rate is 100 beats per minute, respiratory rate is 24 breaths per minute, and oxygen saturation is 92% on room air. There is no jugular venous distention or peripheral edema. Lung examination reveals diffuse crackles in both lung fields. Cardiac examination reveals a regular rhythm with a grade II/VI systolic ejection murmur at the left sternal border. His laboratory values are notable for a B-type natriuretic peptide (BNP) level of 700 pg/mL (normal range: <100 pg/mL).

Based on echocardiography, which option is incorrect?

A 58 y/o woman with history of seizures and pulmonary hypertension is admitted to the CCU with chief complaint of shortness of breath, palpitation, and worsening dyspnea on exertion. Also, she endorsed one episode of syncope. Right heart catheterization showed MPAP of 64 mmHg. In laboratory findings, NT-pro-BNP was 1,240 ng/mL. She was receiving carbamazepine 200 mg BID (for 15 years), amlodipine 10 mg daily, and macitentan 10 mg daily (for 6 months) at the time of admission.

What is your suggestion for the pharmacotherapy of PAH in this patient?

A young patient with narrow complex tachycardia underwent EPS, An EP tracing is shown below.

What is NOT seen in EP tracing?

35 y/o man came to ED with complain of fatigue & orthopnea from 1 month ago. echocardiography was shown :

Which one is NOT seen in this patient?

44-year-old man, with no symptoms, but two siblings experienced sudden cardiac death. ECG is shown below. He had normal electrolyte levels and no apparent heart disease.

What option is NOT present in his ECG?

A middle-aged man with ischemic cardiomyopathy and ICD implantation came with ICD firing. Programming performed.

Tracings are shown below.

Which statement is NOT correct?

A 31 years old woman presented with paroxysmal palpitation.here there is her ECG Holter.

Which statement is NOT correct?

A young lady came with palpitations, she had a previous session of RF ablation 6 years ago for WPW. ECG is shown.

According to the ECG, what is the diagnosis?

A 42-year-old man experiencing frequent palpitations underwent an electrophysiology study (EPS); presented below are two tracings from the study.

Considering the electrophysiology tracing, which arrhythmia is more likely?

A 35 y/o lady came to your clinic for routine checkup. She claimed that she had a congenital heart disease which was corrected many years ago.

according to CXR ,what is your assumption for her past congenital disease?

A 40 y/o man, with no previous PMH came to ED .He was referred by general practitioner for evaluation of AV block, the patient was asymptomatic and received no drugs.

The ECG was done during routine checkup.

What is your diagnosis and management?

A 64-year-old woman, known to be hypertensive and on amlodipine, was diagnosed with breast cancer 6 months ago. She completed 6 cycles of chemotherapy, with the last one administered 4 weeks ago, in preparation for radical mastectomy and axillary clearance.

She presents to the cardiology clinic complaining of shortness of breath. On examination, her blood pressure is 105/80 mmHg, pulse is 90 bpm, and regular. Bibasilar crackles were noted on auscultation of her chest.

Her ECG showed non-specific ST changes in the anterior leads.

Based on this clinical presentation and the chest X-ray (CXR) shown below, what is your diagnosis?