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59F with 1 week history of fast palpitations and giddiness

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 56 F presented with c/o fast palpitations associted with giddiness and sob on exertion since 1 week  on arraival serial ecgs with intervention.  below ecg is after 6 and 12 mg adenosine  not reverted to sinus rhythm with adenosine 12mg patient was started on cardarone infusion  no much change in rhythm and developed tacchycardia wih frequent long pauses.  in view of hypotension with long pauses, emergency TPI was done along with CAG.  next day rhythm reverted to sinus and TPI was removed. 
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47 F recurrent ADHF with inflammatory myocarditis

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Age / Sex: 47-year-old female Comorbidities: Type 2 Diabetes Mellitus Late July / August 2025 (Initial Presentation) Chief Complaints: Giddiness, a single episode of transient loss of consciousness (LOC) lasting approximately 2 minutes, and one episode of vomiting. Pre-Hospital Course: Evaluated at an outside facility where she received an acute coronary syndrome (ACS) loading dose consisting of Acetylsalicylic Acid (Ecosprin) 325 mg, Clopidogrel (Clopitab), and Atorvastatin (Atorva) 80 mg prior to transfer. Emergency Department Presentation: The patient demonstrated profound bradycardia with a pulse rate of 40 bpm and initial hypotension measuring 100/60 mmHg, necessitating immediate inotropic and supplemental oxygen support. Following initial stabilization, vitals normalized to a blood pressure of 130/70 mmHg, respiratory rate of 20/min, and an $SpO_2$ of 98% on room air. Physical Examination: Systemic evaluation revealed adequate bilateral air entry, normal S1/S2 heart sounds ...
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