History:

A 60-year-old male patient with a history of hypertension, hyperlipidemia, and smoking was admitted to the hospital two days ago, with a diagnosis of anterior MI, and underwent primary percutaneous coronary intervention (PCI) to his left anterior descending artery (LAD).

Two days after the PCI, the patient developed symptoms of heart failure, including dyspnea, cough, and fatigue. His blood pressure was 90/60 mmHg, and his heart rate was 110 beats per minute. Physical examination revealed crackles in both lung fields and holosystolic murmur.  His ECG and echocardiography are shown below.

Question:

Based on ECG and echocardiography, which option is more likely to be diagnosed?

Case #712-Samane Sardari

History:

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.

Question:

What is the most appropriate immediate next step in management?

Case #733-Samane Sardari

History:

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.

Question:

Based on the most probable diagnosis suggested by the ECG and echocardiography findings, which of the following choices is correct?

Case #241-Ali Bozorgi

History:

A 73 years old lady, history of CABG 5 years ago, consulted for this ECG to perform RF ablation,

Question:

What is your diagnosis and management?

Case #460-Ali Bozorgi

History:

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

Question:

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

Case #539-Ali Bozorgi

History:

An 83-year-old man underwent recent primary percutaneous coronary intervention (PCI) for the right coronary artery (RCA). Two ECGs in two consecutive days are presented below.

Question:

Which statement is TRUE?

History:

This EKG was observed in a patient with myocardial infarction,

Question:

Which of the following statements about the arrhythmia shown in this EKG, observed in the setting of an acute myocardial infarction, is NOT correct?

Case #614-Ali Bozorgi

History:

A young lady with minimal preexcitation underwent EPS, EP tracings are shown below

Question:

What is the possible diagnosis?

Case #516-Samane Mohamadi

History:

A 64-year-old lady came to your clinic with the chief complaint of palpitation. The 24-hour ECG Holter is shown below:

Question:

What's the  accurate diagnosis for the WCT revealed in ECG holter?

Case #190-Ali Bozorgi

History:

A 28 years old man with preexcitation and episodes of palpitations. ECG is shown below:

Question:

Regarding to accessory pathway location, what procedure related complication does not threat the patient?

Case #545-Samane Mohamadi

History:

A 32-year-old male with a history of palpitation and suspicious of ARVD was admitted to our center for more evaluation.

Here is the patient's  ECG from last night shift.

Question:

As the on-call resident, what's your diagnosis, and what actions would you take?

Case #300-Motahare Hatami

History:

A 37 y/o man came to ED complaining of palpitation which started 3 days ago.

his initial vital sign: BP=110/70   HR=160 beats/min  O2sat=97%

the ECG is shown:

Question:

What is the best treatment strategy in our patient?

Case #169-Ali Bozorgi

History:

A 55 years old lady underwent EPS and Ablation, Two EP Tracing are shown below:

Question:

What is the best explanation for this tracings?

History:

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).

Question:

Based on echocardiography, which option is incorrect?

Case #324-Ali Bozorgi

History:

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.

Question:

What are you going to do?

Case #129-Motahare Hatami

History:

A busy day at emergency department! 4 patient with history of prosthetic valve surgery  come to ED complaining of dyspnea. Fluoroscopies were shown:

Question:

Which statement is TRUE about these patients?

Case #531-AliReza Farzaei

History:

A 38-year-old stable male patient with an unrecorded history of atrial fibrillation (AF) rhythm presented to the Emergency Department (ED) with a chief complaint of palpitations. The electrocardiogram (ECG) is displayed below.

The patient has no drug history.

Question:

Upon reviewing the patient's condition, what do you think about the drug of choice? Furthermore, how do you decide if the preferred drug is not available? (Answers coming up respectively)

Case #717-Ali Bozorgi

History:

Below, you can find the EP tracing of a middle-aged patient with palpitations.

Question:

Which statement is NOT correct?

Case #340-Ali Bozorgi

History:

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

Question:

According to the ECG, what is the diagnosis?

History:
  • An 85 y/o woman was brought to ED by her children. She suffered from dementia so she could not explain her symptoms but her children claimed that their mother has experienced a syncopal attack a few hours before. She did not take any beta-blocker or calcium channel blocker in her drug history.
Question:

According to her ECG what is your next step for her management?

In Loving Memory of

Dr. Maryam Khoshnevis

MD, Cardiologist

Fellowship of Echocardiography

Faculty member of TUMS

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