A 49-year-old woman with a history of chronic myeloid leukemia presents to the emergency department with progressive positional chest pain and dyspnea for one week.
Examination findings:
• Blood pressure: 140/90 mmHg
• Heart rate: 120 bpm
• Jugular venous distension present
• Marked pulsus paradoxus is noted
Which of the following is the most appropriate next step in management?
A 42 y/o male patient with history of atypical chest pain underwent coronary angiography due to positive ETT.
One view from RCA is shown below.
What do you think about the branch that is marked in the picture?
A woman in her 60s underwent cryoballoon ablation for AF. Below are 3 consecutive EP tracings during LUPV cryoablation.
What is the best explanation for these tracings?
A 34-year-old man came to our ED with the chief complaint of palpitation, here are two shots from the intracardiac EGM of his EP study :
What is the most probable diagnosis and the mechanism behind turning 2:1 arrhythmia to 1:1?
A middle-aged man came to the ER for palpitation and presyncope. He received shock at the ED. Below you can find the Arrhythmia ECG, rest ECG, and EP tracing.
What is your diagnosis?
A 40 y/o lady came to ED complaining of acute retrosternal chest pain which was lasted one hour.The patient was asymptomatic at the time of visit, past medical history was unremarkable.The ECG was shown below. Bedside echo showed LVEF about 40 % with regional wall motion abnormality in mid ventricular part of inferior, posterior, anterior, lateral and anteroseptal of LV.
First hs-cTnT = 58 ng/l (with upper limit of 24 ng/l)
What is the most likely diagnosis for this patient?
A 60 y/o man with a history of PCI on LCX comes to ED complaining of acute chest pain and dizziness.
the ECG is shown:
what is your diagnosis and proposed treatment strategy?
A 57 y/old woman was admitted with chest pain, dizziness, and DOE FC2 from one day ago
PMH: NEG., DH: covid vaccination 3 weeks ago
Bp:130/70 PR :78 RR :18 T:37 Sat:97%
Echocardiography: EF:55% ,mild MR. Mild to mod TR. TRG 26 PAP:31 no RWMA. NO LV clot
Lab data: cr:1.1 _LDL:157 _CRP :3.6 WBC:11500 _PMN:78% Trop: neg
He was referred to the cath lab for coronary angiography.
Angiogram is shown
Which diagnosis is most appropriate for this patient?
A 56-year-old male came to ER with palpitation since 1 hour ago.
Below you can find the arrival ECG.
Vital sign:Bp:126/75-PR:180_190
What is the suitable action?
A young lady with palpitation underwent EPS and ablation. Surface resting ECG is shown.
What is the most probable diagnosis of the patient's arrhythmia?
Below is the 12-lead ECG of a patient who underwent EPS. Prior to this tracing, we were attempting to capture the "His" signal."
Which statement is wrong?
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:
What is your next preferred step for this patient?
A 45 years old male patient with frequent episodes of palpitation for 3-4h with on/off phenomenon, in the telemetric ECG monitoring we could catch these episodes of SVT.The patient has no another medical history, no medication.
What ist the most probable mechanism of this tachycardia?
A 40 y/o asymptomatic patient evaluated for ejection type systolic murmur.
Echocardiography is shown.
What is the most likely diagnosis?
A 24-year-old man arrived at the emergency department complaining of pleuritic chest pain that commenced shortly after the initiation of playing tennis.
The patient's vital signs were documented as:
Blood pressure: 100/50 mmHg
Heart rate: 105 beats per minute
Respiratory rate: 18 breaths per minute
Temperature: 36.5°C
Those are the initial ECG that was taken 10 minutes after arrival:
What is the best next management strategy?
A 63 y/o lady with LVEF=40% and Mild CAD, All ECG tracing showed irregular arrhythmia, three are shown:
What is the rhythm in this lady with tachycardia induced cardiomyopathy?
A 76-year-old lady with past medical history of hypertension, opium addiction, ischemic heart disease and permanent pacemaker presented with chief complaint of severe at rest chest pain. ECG showed no ischemic changes. There was mild increase on troponin. Transthoracic echocardiography showed normal ejection fraction,no regional wall motion abnormality, no significant valvular abnormality, normal right ventricle and dilated ascending aorta.
CT Angiography of aorta with and without contrast was done:
what is the diagnosis?
A young boy with frequent palpitations, below you can find EP tracing of arrhythmia and also post-pacing interval.
What is the most probable diagnosis?
A middle-aged lady with a history of aortic valve replacement underwent a diagnostic angiogram due to Brady dysrhythmia, ECG and CAG are shown:
What is Brady dysrhythmia, and what is the most probable cause?
A 52-year-old woman with episodes of syncope underwent a Brugada challenge test, in which she was given 400 mg of oral flecainide. The results of the test are shown below.
What statement is wrong?
In Loving Memory of
Dr. Maryam Khoshnevis
MD, Cardiologist
Fellowship of Echocardiography
Faculty member of TUMS