| Volume | Abstract | Supervisor |
| 1 |
ECG showing LBBB, with multiple spikes over ascending limb of the T-wave of every other beat. |
Dr. Hussien Rizk. |
| 2 |
ECG of a 68 year old man, with calcific aortic stenosis and CHF.
What is the diagnosis?
|
Dr. Hussien Rizk. |
| 3 |
A 68 years old patient was admitted to the CCU with severe typical ischemic chest pain lasting for 4 hours before admission.
The immediate ECG showed wide QRS.
What is the diagnosis?
|
Dr. Hussien Rizk. |
| 4 |
Supraventricular tachycardia at a QRS rate of 150/min. and regular, atrial activity at double the ventricular rate is most evident in leads II, III & aVF. This suggests the diagnosis of atrial flutter. |
Dr. Hussien Rizk. |
| 5 |
Acute inferior myocardial infarction is frequently associated with various degrees of heart block.
HB is usually related to occlision of the posterior descending artery supplying the AVN-artery. It may be seen as first degree HB only, or may progress to complete HB in the same patient. This will further compromise the coronary circulation. |
Dr. Hussien Rizk. |
| 6 |
ECGs of a patient with tight MS. She was subjected to balloon valvuloplasty. Different conduction defects and varieties of arrhythmia was recorded before and after dilatation. |
Dr. Hussien Rizk. |
| 7 |
A 65 year old lady who was referred for routine preoperative evaluation. Pulse was slow and irregular. The first look of some form of A-V block and VPBs.
|
Dr. Hussien Rizk. |
| 8 |
A 34 year old female with progressive dyspnea grade II-III/VI, moderate mitral stenosis (MVA 1.3 cm2) and mild aortic incompetence. ECG showed first degree heart block together with runs of non-sustained wide complex tachycardia showing LBBB configuration and inferior axis together with AV dissociation denoting VT arising from the RVOT. |
Dr. Sherif El Degwy, Dr. Hesham Yehia. |
| 9 |
A brief recent review of the management of sustained and non-sustained VT. The presentation will include; the rapid assessment, acute management , risk stratification, and long term management according to the recently published recommendations and trials.
|
Dr. Karim Said. |
| 10 |
This 60 year old lady underwent mitral valve replacement for rheumatic mitral valve disease together with Maze procedure to treat resistant atrial fibrillation three years ago.
Atrial pacing was done. She presented with tachycardia and severely impaired left ventricular dysfunction.
What is your ECG diagnosis?. The Patient is in CHF. |
Prof. Dr. Hussien Rizk. |
| 11 |
A 58 year old gentleman with dilated cardiomyopathy since 1989. He had progressive heart failure in spite of intensive medical therapy. Echocardiogaphy revealed dilated LV with LVEDD and LVESD of 9.0 and 8.0 cm respectively and an EF of 22%. The decision was to implant a biventricular pacemaker. This was the first case done in the Cardiology Department, Cairo University. |
Prof. Sherif El Degwi and Dr. Hesham Yahia. |
| 12 |
A 43 year old lady who presented within the last 4 months by recurrent witnessed episodes of syncope of 10-15 minutes duration that were preceded by lightheadedness and shortness of breath. The only abnormal finding was her ECG with bifascicular block. |
Dr. Hesham Yahia. |
| 13 |
A 32 year old lady with rheumatic heart disease, mitral stenosis (MVA 1.3 cm2), complaining of dyspnea FCII that deteriorates during episodes of rapid regular palpitations and is associated with dizziness. Her basic ECG shows left atrial enlargement. During tachycardia (about 180 bpm), QRS complex is narrow with RP interval shorter than PR interval. The patient was subjected to EP study that revealed a lateral concealed bypass tract for which she had successful ablation through retrograde transaortic approach. |
Dr. Sherif El Degwi. |
| 14 |
A 35 year old athlete with sinus bradycardia and history of bouts of dizziness with hypotension. Interestingly, he was accidentally discovered to have pre-excitation pattern on the surface ECG. On physical exercise, his heart rate accelerates to 120 bpm. Previous Holter monitor showed a heart rate of 32 bpm during sleep. Lately he was admitted to the intensive care with near syncope and slow heart rate of 40 bpm. His blood pressure was 80/50 mmHg. Intravenous atropine was given with acceleration of the heart rate to 58 bpm. |
Dr. Hesham Yahia. |
| 15 |
A 25 year old lady, with history of rheumatic fever and intermittent pre-excitation, presenting for preoperative assessment for cholecystectomy. She underwent electrophysiological study without induction of tachycardia. Her surface ECG shows intermittent pre-excitation. The pre-excited beats show a left sided accessory pathway possibly posterior or posterolateral. |
Dr. Hesham Yehia. |
| 17 |
A 54 year-old lady with recurrent episodes of syncope. Twenty-four hour Holter monitoring revealed episodes of complete heart block and asystole the maximum recorded was about 45 seconds followed by ventricular escape beats and regaining normal sinus rhythm. A permanent dual chamber pacemaker was implanted for the patient with abolishment of her symptoms. |
Hesham Yehia |
| 18 |
A 44 year old gentleman with recurrent history of palpitation that is documented to be of narrow complex tachycardia. Electrophysiological study revealed a left sided posterolateral accessory pathway. RF ablation of the accessory pathway was retrogradely through the aorta. |
Dr. Hesham Yehia |
| 19 |
- A 17 year old student that presented with recurrent attacks of palpitations and syncope. He has no structural heart disease. The resting electrocardiogram shows Wolf Parkinson White Syndrome manifesting as a delta wave with short PR interval. During palpitation, there is a narrow complex tachycardia at a rate of 240 bpm with retrograde P waves. The QRS complex shows the feature of electrical alternans raising the possibility of an orthodromic reciprocating tachycardia. |
Dr. Sherif Eldegwi & Dr. Hussein Heshmat |
| 20 |
A 57 year old lady with history of hypertension and type II diabetes mellitus. She presented with episodic palpitations that were associated dizziness (BP 90/60). It was documented to be a ventricular tachycardia of RVOT origin. The electrocardiogram shows a wide QRS complex tachycardia with left bundle branch block morphology and left inferior axis deviation (ECG 1). |
Dr. Hesham Yehia. |
| 21 |
A 28 year-old, male with recurrent paroxysms of rapid regular palpitation associated with shortness of breath and giddiness. Clinical examination was entirely normal. The resting ECG is normal. The patient underwent electrophysiological (EP) study for arrhythmia interpretation and management... |
Prof. Sherif El Degwi, MD, Dr. Hesham Yehia, MD |
| 23 |
This is a rhythm strip from a patient with history of complete heart block and sick sinus syndrome for whom a dual chamber pacemaker was implanted. The pacemaker upper rate limit is set at 110 bpm. |
Dr. Hesham Yehia. |
| 25 |
A 15-year-old female presented to emergency department of Suez Canal University Hospital with Complete Heart Block (CHB) and syncope. After detailed investigation, she is diagnosed as familial non-obstructive Hypertrophic Cardiomyopathy (HCM) with a rare form of its associated complication (CHB), and subsequent DDD permanent pacemaker inserted to her, with good follow- up results. HCM associated with CHB is a rare association, but can cause sudden cardiac death and syncope. |
Ahmed Tageldien, Mervat A.Maaty |
| 23 |
By; Prof. Sherif El Degwi, Prof. Mervat Abu El Maaty, Prof. John Onufer and Dr. Hesham Yehia.
A Case of Multiple Accessory Pathways.
A 34 year-old male patient has presented by recurrent palpitations. The attacks were not precipitated by exertion and were relieved spontaneously.
His ECG showed a pattern of LBBB with a delta wave that is positive in II, III and aVF and negative in V1-V3 suggesting the presence of a manifest right sided anteroseptal accessory pathway.
The patient was scheduled for electrophysiologic study and radiofrequency ablation. |
S.Degwi, Mervat A.Maaty, John Onufer, H.Yehia |
| 27 |
Discussed By:
Prof. Mervat AbuElMaaty, Prof. Sherif ElDegwi, Dr. Hesham Yehia, Dr. Amir AbdelWahab
A 24 year-old male patient has presented by recurrent palpitations.
The condition started since 2001, when he started to experience recurrent attacks of regular rapid palpitations of sudden onset and offset and variable duration associated with dizziness. The attacks were not precipitated by exertion and were relieved spontaneously. They used to recur 2-3 times weekly despite taking different anti-arrhythmic medications. |
How Many Accessory Pathways |
| 28 |
|
How Many Accessory Pathways |
| 29 |
A 57 year old gentleman with ischemic cardiomyopathy. He had been on ICD therapy for 5 years for life-threatening ventricular arrhythmias. Recently, after the innovation of biventricular pacing and several studies that showed the benefit of biventricular pacing in heart failure patients, his device was changed to a biventricular ICD one.
He remained fine for a while however unfortunately he started to experience multiple therapeutic shocks delivered by the ICD, the most frequent of them was 7 in 24 hours. The patient was hospitalized. The resting ECG (ECG 1) shows atrial flutter at a rate of about 250 bpm with some paced beats at a rate of 60 bpm and other beats that are not paced with occasional pseudofusion beats. |
Dr. Hesham Yehia |
| 30 |
Prof. Mervat Abu ElMaaty, Prof. Sherif ElDegwi, Dr. Hesham Yehia, Dr. Amir AbdelWahab
An 18 year-old male student who underwent a successful arterial switch procedure in 1991 presented to us with recurrent palpitations.
This gentleman was born with transposition of the great arteries and intact interventricular septum. In 1990, he underwent pulmonary artery banding with aortopulmonary shunt followed in 1991 by arterial switch procedure. Both were done in England by Sir. Magdi Yacoub.
He was asymptomatic till 6 months ago when he started to experience recurrent attacks of regular rapid palpitations of sudden onset and offset and variable duration associated with dizziness |
Prof. Mervat Abu ElMaaty |
| 31 |
Ablation Of Incessant Atrial Arrhythmia
A 64 years old male patient, ex-smoker, hypertensive on valsartan 80 mg, and not known to be diabetic with no other medical history of significance.
He started to complain of rapid regular palpitations 45 days ago ,he claimed it to be intermittent, he received amiodarone loading dose, also verapamil and propafenone was tried but the tachycardia was incessant . The resting ECG showed typical anticlockwise atrial flutter with a rate of 130 bpm. He was refered to us for electrophysiological study. |
Dr. Hisham Yehia, Dr. Ahmed El-Damaty |
| 32 |
Ablation for Ischemic VT
A 65 year-old ex-smoker female patient with known history of IHD was referred due to multiple shocks from her ICD.
She sustained an inferior MI in 1997 treated by early thrombolysis with preserved LV function. Coronary arteriography at that time did not show significant CAD. In 2001, she started to describe typical exertional anginal pains. Coronary catheterization showed significant LAD disease which was successfully stented. She was asymptomatic till 2004 when she started to experience increased shortness of breath with no clear chest discomfort. Coronary arteriography at that time showed patent LAD stent with 70% RCA lesion that was successfully stented. Exercise stress test done at that time was negative for ischemia |
Dr. John Sapp, Dr. Amir A.Wahab |
| 33 |
ECG with continuous artifacts.
A 54 year old female came for regular check up for a permanent VVI-pacemaker. She had occasional palpitations. She was over weight and also complaining of recurrent backache. She has a long standing history of gastritis.
Recording an ECG to assess the VVI-device showed frequent artifacts which did not disappear in spite of changing the electrodes.
|
Prof. Hussien Rizk |
| 35 |
Not available |
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| 36 |
Not available |
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| 37 |
- A 59 years old female.
- Risk factors: hypertensive, hyerlipidemic, non diabetic and non smoker.
- Old anterior MI of 2 years duration.
- Reappearance of chest pain of 2 months duration.
- ECG: inferolateral T wave changes.
- DSE: non viable LAD and ischemic RCA territory. |
Dr. Ahmed Khashaba |
