Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            bed by the Pt. 
How to evaluate palpitation/
-Continuos or intermitent.
-Regular or irregular.
-Precepitating factors, exercise, alcohol use.
-Abrupt or gradual onset.
-Associated symptoms of chest pain, dyspnea.
-History of valvular disease or CAD.
CAD investigations
Chest X-ray/ to assess size & shape of heart, pulmonary
vessels & lung fields, PA & lateral views, cardiomegaly
caused by chamber dilatation or pericardial effusion.
Lung fields may show congestion & edema ,pleural 
effusion in heart failure.
Echocardiography/ placing US transducer on chest wall.
Indications:  -assessment of LV function.
-Valve structure, disease & severity.
-Diagnosis of endocarditis.              -Detect pericardial effusion.
-Detect intracardiac thrombus.      - Detect cardiomyopathy.  
-Detect congenital heart disease.
CAD Investigations
Trans-esophageal Echo/passing endoscope like
US probe in esophagus to assess different aspects of 
heart in higher resolution than transthoracic echo.
Stress Echo/assess CAD for those with mobility
problems, echo done before & after infusion of is
inotropic agents (dobutamine).
CT/ to assess heart chambers, pericardium, mediastinal
structures, masses, lungs.
CT coronary angiography/ for initial assessment of
CAD.
MRI/ better to assess soft tissues than CT, myocardial infilterative
disease, aortic dissection.
CAD Investigations
Cardiac catheterisation/ passing catheter through
perepheral artery or vein into the heart under X-Ray
guidance to assess intracardiac pressure & O2 saturation.
to perform angiogram by injecting contrast media
into chambers & vessels.
Electrophysiology/ to assess Pt. with arrhythemia
by placement of electrode catheter into the heart
to study & ablation procedures.
Radionuclide imaging/ to assess cardiac function now
replaced by MRI.
Myocardial perfusion scan/ by injecting IV radioactive isotope
to assess myocardial perfusion at rest & after exercise, now  
replaced by PET scan.
CAD Investigations
Cardiac  troponins/ Troponin I & Troponin T are
structural cardiac muscle protiens that reliesed
during myocyte damage & necrosis, represent 
the cornerstone of the diagnosis of acute MI.
More sensitive tests now detect minor degree
of myocardial damage also in pulmonary 
embolism, pulmonary edema & septic shock.
Eletrocardiography ECG
Used to study cardiac rhythm & conduction, is the 
main test to diagnose myocardial ischemia. electric
depolaraisation of myocardium produce a small
Dipole current ,detected by electrode pairs on body
surface, these signals amplified &printed or dyploid
on monitor.
During sinus rhythm the SA node triggers aterial
depolaraisation producing P wave. depolaraisation
proceeds slowly through AV node which is too small 
to produce a depolaraisation wave detectable from body
surface. bundle of HIS, bundle branches & purkinje system are then
activated initiating myocardial depolaraisation which produce the QRS
complex. the muscle mass of ventricle is much larger than atria, the QRS complex
i

            Quiz: