Male 54 years, doesn't know how he got a sewing needle in hi | Figure 1

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Male 54 years, doesn't know how he got a sewing needle in his heart. Suffered from depression after divorce, drank a lot of alcohol, after that he was admitted to hospital for pericarditis, cardiothoracic surgeon said the risk is larger than benefit. 2 years after he complains for recurrent pain in all joints and fevers. What do you think?

32 yo male patient with a history of syncope playing soccer several years ago. States he had an echo after that and there was ‘something wrong‘ with the right side of this heart. HE now shows up in your er with this ekg. What could be his diagnosis?

Male 55 years old, who came to the emergency room presenting a wound in the eyebrow after fall at the street. He gets 9 stitches. Then he presents 8 days after, to get off the stitches.

76 years. Controlled hypertension. Excellent general condition. Varicose veins appeared spontaneously in this region when he was 65. After eleven years of evolution he is in the hospital for replacement of a VDD pacemaker after AV complete block when he was 67. No more venous or arterial or any other medical problems or conditions.

35 year old male came in with femur fracture after skydiving accident. Unsure of exact plan after he was admitted from the ER. Surprisingly he wasn't in a lot of pain upon arrival.