Case #631-Ali Bozorgi

History:

A young lady with preexcitation underwent EP ablation. Post-ablation, Adenosine was administered to block the AV node and confirm successful accessory pathway ablation. Below is the tracing following the procedure: 

Question:

Which statement is wrong?

Case #162-Ali Bozorgi

History:

A 65 years old man admitted for frequent ICD shock, one episode of tracing shown below (movie)

Question:

What is the best explanation for the shock?

Case #274-Ali Bozorgi

History:

A 79 years old patient with frequent palpitations. ECG Holter tracings and EP tracings are shown:

Question:

What is the most possible diagnosis?

Case #542-Samane Mohamadi

History:

A 68-year-old male, cigarette smoker, presented with dizziness and dyspnea.
here there are the ECG of the patient's arrival and the ECG in the course of admission.

Question:

Which statement is correct?

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 #337-Ali Bozorgi

History:

An EP tracing of a patient with arrhythmia is shown.

Question:

What is the beat encircled?

Case #338-Ali Bozorgi

History:

Below you can find EP tracing of a patient with paroxysmal AF who underwent cryoballoon AF ablation.

Question:

what happened?

History:

A 77 y/o man presented with TCP & diaphoresis from the last day, He is an active smoker.

Lab data: Trop:598 /cr:1 /Hb:13.5 /CRP:1.26 /PLT: 175000 /k:4.6

ECG: NSR, NAX No significant ST-T changes

Echo: LVEF=35%  with significant RWMA in ant circulation. No lv clot 

Coronary Angiography is shown:

 

Question:

What is the most common etiology of this condition? What is the most common manifestation?

Case #638-Shayan Shahi

History:

A 72-year-old man with a known history of Parkinson’s disease presented to our ED with a chief complaint of palpitations. Below is the intracardiac EGM from his EP study.

Question:

What is the diagnosis, and what is the most likely mechanism behind the variation in Tachycardia Cycle Length (TCL)?

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 #776-Ali Bozorgi

History:

A 52-year-old lady with frequent palpitations, below you can find the ECG and EP tracing.

Question:

What is the most likely diagnosis?

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?

Case #199-Sarah Taaghi

History:

A 50 y/o male patient was admitted in the ICU, due to severe head trauma. He was unconscious (GCS:6) and his past medical history was not clear.
His SBP was 145 mmHg at the time of admission.Emergent craniotomy and hematoma drainage was performed and he was stable in the first day.

Cardiology consult was requested due to rise in Troponin level and ECG changes. 
In day 2, he became hypotensive, that was refractory despite initiating vasopressor agent.
You can find brain CT scan and ECG below.

 

Question:

What’s the best choice ?

Case #625-Ali Bozorgi

History:

A middle-aged patient with a history of atrial septal defect (ASD) repair underwent an electrophysiology study (EPS) with Precision. Below, you can find the propagation and sparkle map.

Question:

What is the most probable mechanism of arrhythmia? 

Case #774-Siroos Nasiri

History:

A 55-year-old man with palpitations and WCT on surface ECG and history of successful previous VT ablation, referred for ablation. Surface ECG is shown:

Question:

Where is VT origin?

Case #271-Ali Bozorgi

History:

A 29 years old man with Tachycardia and low LVEF(25%) underwent EPS and ablation, Surface ECG and EP tracing are shown.

Question:

What is probable etiology of cardiomyopathy?

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 #215-Motahare Hatami

History:

A 60y/o man with a history of coronary artery disease and heart failure with EF=15% came to ED complaining of palpitation.ECG of tachyarrhythmia and previous ECG in sinus rhythm are shown:

Question:

What is your most likely diagnosis?

Case #379-Ali Bozorgi

History:

A middle-aged patient with no structural heart disease came to ED with syncope. ECG is shown.

Question:

Based on 12 lead ECG what are your diagnosis and plan?

Case #103-Motahare Hatami

History:

A 39 y/o female patient admitted to ED complaining of sudden onset episode of chest pain, bed side echocardiography showed LVEF about 35 %.

Two ECG tracings & Coronary angiography were shown:

 

Question:

At the time of your visit the patient was asymptomatic, which one of the following options is NOT an appropriate management plan for this patient?

In Loving Memory of

Dr. Maryam Khoshnevis

MD, Cardiologist

Fellowship of Echocardiography

Faculty member of TUMS

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