The Crimson Circuit Ten cases. Follow the evidence.
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0 of 10 dossiers closed YOUR BUREAU RECORD Junior investigator — XP · — bonus credits
Unlock bonuses Case archive 0 / 66 solved 33 clinical cases · 33 Rhythm Rapid Fire cases
Assign the next ten unsolved dossiers → Browse archiveAll dossiers Clinical cases Rhythm Rapid Fire Unsolved dossiers The vanishing descent Sinus rhythm · Venice The towering V Atrial fibrillation · Paris The double agent Atrial flutter · Istanbul The right-sided signature Sinus rhythm · Cairo The pressure border Sinus rhythm · Jaipur The rigid envelope Sinus rhythm · Kyoto The warm-handed suspect Sinus rhythm · San Francisco The empty vault Sinus rhythm · Buenos Aires The runaway pulse Ventricular tachycardia · London The last course Sinus rhythm · Montréal The innocent tracing Sinus rhythm · Archive 1 The upstream resistance Sinus rhythm · Archive 2 The enlarged chamber Sinus rhythm · Archive 3 The rigid myocardium Sinus rhythm · Archive 8 The narrow right-hand gate Sinus rhythm · Archive 10 The failing right ventricle Sinus rhythm · Archive 14 The missing sympathetic signal Sinus rhythm · Archive 16 The returning aortic flow Sinus rhythm · Archive 17 The congenital return route Sinus rhythm · Archive 18 The fixed outflow barrier Sinus rhythm · Archive 19 The moving obstruction Sinus rhythm · Archive 20 The sudden mitral breach Sinus rhythm · Archive 22 The acute aortic breach Sinus rhythm · Archive 23 The scar in the record Sinus rhythm · Archive 24 The blocked coronary route Sinus rhythm · Archive 25 The inflammatory signature Sinus rhythm · Archive 26 The warm but flooded courier Sinus rhythm · Archive 27 The surplus that failed Sinus rhythm · Archive 28 The click behind the curtain Sinus rhythm · Archive 29 The faint at the needle Sinus rhythm · Archive 30 The trapped breath Sinus rhythm · Archive 31 The echo after the extra beat Ventricular bigeminy · Edinburgh Two locks on the same door Complete heart block · ventricular escape · Prague Rhythm Rapid Fire Non-sustained VT · Sinus Baseline · Signal station 1 Rhythm Rapid Fire Non-sustained VT · Atrial Fibrillation Baseline · Signal station 2 Rhythm Rapid Fire Sinus rhythm with pauses · Signal station 3 Rhythm Rapid Fire Sinus arrest · prolonged pauses · Signal station 4 Rhythm Rapid Fire Sinus arrhythmia · Signal station 5 Rhythm Rapid Fire Atrial bigeminy · conducted PACs · Signal station 6 Rhythm Rapid Fire Multifocal atrial tachycardia · Signal station 7 Rhythm Rapid Fire First-degree AV block · Signal station 8 Rhythm Rapid Fire Mobitz I · Wenckebach · Signal station 9 Rhythm Rapid Fire Mobitz II · 3:2 conduction · Signal station 10 Rhythm Rapid Fire Atrial sensed · ventricular paced · Signal station 11 Rhythm Rapid Fire Atrial paced · ventricular paced · Signal station 12 Rhythm Rapid Fire Pacemaker-mediated tachycardia · Signal station 13 Rhythm Rapid Fire CRT · biventricular pacing · Signal station 14 Rhythm Rapid Fire Ventricular pacing · VVI capture · Signal station 15 Rhythm Rapid Fire Junctional rhythm · Signal station 16 Rhythm Rapid Fire Idioventricular / accelerated ventricular rhythm · Signal station 17 Rhythm Rapid Fire Polymorphic ventricular tachycardia · Signal station 18 Rhythm Rapid Fire Pre-excited atrial fibrillation · Signal station 19 Rhythm Rapid Fire Atrial tachycardia · 1:1 · Signal station 20 Rhythm Rapid Fire AVNRT · typical · Signal station 21 Rhythm Rapid Fire AF with CHB · ventricular escape · Signal station 22 Rhythm Rapid Fire AF with CHB · junctional escape · Signal station 23 Rhythm Rapid Fire Complete heart block · ventricular escape · Signal station 24 Rhythm Rapid Fire High-grade AV block · 3:1 · Signal station 25 Rhythm Rapid Fire AVRT · orthodromic · Signal station 26 Rhythm Rapid Fire Atrial fibrillation · Signal station 27 Rhythm Rapid Fire Atrial flutter · Signal station 28 Rhythm Rapid Fire Ventricular bigeminy · Signal station 29 Rhythm Rapid Fire Ventricular trigeminy · Signal station 30 Rhythm Rapid Fire Ventricular tachycardia · Signal station 31 Rhythm Rapid Fire Ventricular fibrillation · Signal station 32 Rhythm Rapid Fire Complete heart block · junctional escape · Signal station 33
01 Venice 02 Paris 03 Istanbul 04 Cairo 05 Jaipur 06 Kyoto 07 San Francisco 08 Buenos Aires 09 London 10 Montréal 01 Read the evidence 02 Name the suspects 03 Change the outcome
DOSSIER 01 / VENICE
The vanishing descent An investigator returns from a procedure with worsening breathlessness, distended neck veins and hypotension. Somewhere in these pressures, a descent has disappeared.
● EVIDENCE CAPTURE · 6 SECONDS
HR 105 bpm BP 85/65 mmHg Forward CO 2.8 L/min Wedge mean 19 mmHg
Waveform evidence ShowAll traces ECG II ART RA RV PA PAWP 04 RV 32/18 mmHg systolic / EDP Mean 19 mmHg
05 PA 32/19 mmHg systolic / diastolic Mean 22 mmHg
0/12 pinned Your evidence board is empty. Pin an interesting point from a trace above.
Your deduction CLINICAL CONTEXT
Intercepted intelligence YOUR DEDUCTION
Identify the diagnosis Major pathology Select pathology… Heart Failure · Preserved Output Acute Myocardial Infarction Acute Myocarditis Acute Severe Aortic Regurgitation Acute Severe Mitral Regurgitation Cardiac Tamponade Cardiogenic Shock Chronic Severe Aortic Regurgitation Chronic Severe Mitral Regurgitation Constrictive Pericarditis Dilated Cardiomyopathy Anaphylactic Shock High-Output Heart Failure Hypertrophic Obstructive Cardiomyopathy Hypovolemic Shock Ischemic Cardiomyopathy Neurogenic Shock Precapillary Pulmonary Hypertension Preserved Restrictive Cardiomyopathy Septic Shock Severe Aortic Stenosis Severe Mitral Stenosis Mitral Valve Prolapse Severe Pulmonic Regurgitation Severe Pulmonic Stenosis Severe Right Ventricular Failure Severe Tricuspid Regurgitation Severe Tricuspid Stenosis Tension Pneumothorax · Obstructive Shock Vasovagal Response Cardiac rhythm Select rhythm… Sinus Rhythm Atrial Fibrillation Atrial Flutter Ventricular Bigeminy Atrial Bigeminy Ventricular Trigeminy Sinus Arrhythmia Atrioventricular Nodal Reentrant Tachycardia Atrioventricular Reentrant Tachycardia Atrial Tachycardia Multifocal Atrial Tachycardia Pre-Excited Atrial Fibrillation First-Degree Atrioventricular Block Mobitz I (Wenckebach) Mobitz II High-Grade Atrioventricular Block Complete Heart Block · Junctional Escape Complete Heart Block · Ventricular Escape Sinus Pauses Sinus Arrest Junctional Rhythm Atrial Fibrillation + Complete Heart Block · Junctional Escape Atrial Fibrillation + Complete Heart Block · Ventricular Escape Ventricular Pacing (VVI) Atrial Sensed · Ventricular Paced Atrial Paced · Ventricular Paced Biventricular Pacing · Cardiac Resynchronization Pacemaker-Mediated Tachycardia Non-Sustained Ventricular Tachycardia · Sinus Baseline Non-Sustained Ventricular Tachycardia · Atrial Fibrillation Baseline Monomorphic Ventricular Tachycardia Polymorphic Ventricular Tachycardia Ventricular Fibrillation Idioventricular Rhythm Lock in verdict
The decisive move Confirm both suspects to unlock the kit.
Case file open · available score: 100 / 100