====== Key Points ======
Arythmogenic right ventricular dysplasia has BOTH:
    * fat in RV wall
    * wall motion abnormality

===== Signs of Right Heart Dysfunction =====
  * Straightening or reversal of intraventricular septum
  * Dilitation of right ventricle
  * Collapse of R ventricular free wall

===== Radiology Signs of Hemodynamically Significant Stenosis =====
  * Collaterals
  * Post-stenotic dilitation
  * Parvus tardus waveform
  * Aliasing
  * Differential enhancement

===== CXR Signs of Pericardial Effusion =====
  * Globular, flask, or water-bottle shaped heart
  * No significant pulmonary venous congestion
  * Loss of retrosternal clear space
  * Fat-pad sign - Oreo sign
  * Seprataion of retrosternal fat from epicardial fat line > 2mm (15%)
  * Co-existent pleural effusions (1/3)
===== Abnormal Catheter Locations on Lateral =====
  * Internal mammary vein - anterior
  * PAPVR - middle
  * L SVC - middle (towards coronary sinus)
  * L superior intercostal - posterior

===== Causes of Ascending Aortic Aneurysms =====
  * Post-stenotic dilitation
  * Mycotic
  * Syphilitic
  * Sinus of Valsalva aneurysm
  * Cystic medial necrosis (see below)

===== Cystic Medial Necrosis =====
  * KEY FINDING is an aneurysm that crosses the **sinotubular junction**
  * Annuloaortic ectasia is the buzzword
  * Tulip-bulb appearance
  * Predominantly associated w/ Marfan's
===== LV Aneurysms =====
^ True                              ^ False                              ^
| Wide Base                         | Narrow Neck                        |
| Delayed Enhancement of Myocardium | Delayed Enhancement of Pericardium |
| More Common                       | Less Common                        |
| Anterolateral Wall                | Posterior Wall                     |
| Treated w/ Anticoagulation        | Treated Surgically                 |

====== Differentials ======

===== Infiltrative Disorders of Myocardium =====
  * Lymphoma
  * Sarcoid
  * Glycogen Storage Diseases
  * Amyloid
===== Hypertrophic Cardiomyopathy =====
  * Idiopathic
  * HTN
  * Aortic Stenosis
  * Coarctation

===== Cardiac Masses =====
  * Thrombus - most common
  * Metastases
    * breast
    * lung
    * melanoma
    * lymphoma
    * sarcoma
  * Primary benign masses
    * Myxoma (adults, atrial septa)
    * Hemangioma (lightbulb enhancement)
    * Rhabdomyoma (children, regress by adulthood, free wall of RA)
    * Lipoma
  * Primary malignant masses
    * Sarcoma
    * Rhabdomyosarcoma (children)
  * Vascular extension of tumor
    * RCC, HCC, ACC, endometrial, Wilm's
      * Intrachamber involvement
    * Lung CA
      * Pulmonary vein extension
  * Valvular masses
    * Elastofibroma
    * Myxoid degeneration
    * Vegetations

===== Pericardial Effusion =====
  * Serous
    * uremia, CVD, myxedema
  * Bloody
    * infarct, trauma, neoplasm
  * Purulent
    * bacterial, viral, TB

===== Small Cardiac Silhouette =====
  * COPD
  * Hypovolemia
  * Addison's disease

===== Pulmonary Artery Stenoses =====
  * Takayasu's
  * Chronic PE
  * Fibrosing mediastinitis
  * Webs

===== Causes of PA Pseudoaneurysms =====
  * trauma
  * iatrogenic
  * mycotic

===== Causes of Pulmonary HTN =====
  * Precapillary - obstruction in the central PAs from thromboembolism, tumor, or hypoplastic PAs
  * Capillary - interstitial lung dz, COPD, pneumonectomy, primary pulmonary HTN, Eisenmenger, and widespread airspace disease such as atelectasis, pneumonia, tumor
  * Postcapillary - LV failure, restrictive cardiomyopathy, mitral stenosis, hypoplastic left heart, pulmonary veno-occlusive dz, and fibrosing mediastinitis

====== Facts ======

===== Constrictive Pericarditis =====
  * Thickened pericardium (does not have to be calcified)
  * Cone-shaped RV
  * D-shaped LV
  * Paradoxical motion of intraventricular septum
  * Sigmoid configuration of intraventricular septum
===== Hypertrophic Obstructive Cardiomyopathy (HOCM) =====
  * Asymmetric septal hypertrophy
  * Systolic anterior motion of mitral valve

===== Myocardial Ischemia/Infarct =====
==== Patterns of Enhancement ====
  * Endocardium - infarct
  * Epicardium - inflammatory process such as sarcoid

==== Ischemia ====
  * Has decreased early enhancement
  * No delayed enhancement

==== Infarct ====
  * Initial Perfusion Defect
  * Delayed Hyperenhancement (10-15 min delayed images)
  * Cine Imaging with Corresponding Wall Motion Abnormality

===== Moderator Band =====
  * One of the trabeculae carneae in the right ventricle of the heart
  * Carries part of the right branch of the AV bundle from the septum to the anterior papillary muscle on the opposite wall of the ventricle

===== Holt-Oram Syndrome =====
  * ASD and absent radius
===== Coronary Artery Anomalies =====
  * L main origin from R leaflet
  * L main origin from PA (ALCAAPA - Anomalous Left Coronary Artery Arising from Pulmonary Artery)
  * L main arises from R leaflet and travels anterior to PA
    * Seen in congenital heart disease such as Tetralogy