Arythmogenic right ventricular dysplasia has BOTH:

• fat in RV wall
• wall motion abnormality

• Straightening or reversal of intraventricular septum
• Dilitation of right ventricle
• Collapse of R ventricular free wall

• Collaterals
• Post-stenotic dilitation
• Parvus tardus waveform
• Aliasing
• Differential enhancement

• 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)

• Internal mammary vein - anterior
• PAPVR - middle
• L SVC - middle (towards coronary sinus)
• L superior intercostal - posterior

• Post-stenotic dilitation
• Mycotic
• Syphilitic
• Sinus of Valsalva aneurysm
• Cystic medial necrosis (see below)

• KEY FINDING is an aneurysm that crosses the sinotubular junction
• Annuloaortic ectasia is the buzzword
• Tulip-bulb appearance
• Predominantly associated w/ Marfan's

• Lymphoma
• Sarcoid
• Glycogen Storage Diseases
• Amyloid

• Idiopathic
• HTN
• Aortic Stenosis
• Coarctation

• 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

• Serous
  • uremia, CVD, myxedema
• Bloody
  • infarct, trauma, neoplasm
• Purulent
  • bacterial, viral, TB

• COPD
• Hypovolemia
• Addison's disease

• Takayasu's
• Chronic PE
• Fibrosing mediastinitis
• Webs

• trauma
• iatrogenic
• mycotic

• 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

• Thickened pericardium (does not have to be calcified)
• Cone-shaped RV
• D-shaped LV
• Paradoxical motion of intraventricular septum
• Sigmoid configuration of intraventricular septum

• Asymmetric septal hypertrophy
• Systolic anterior motion of mitral valve

• Endocardium - infarct
• Epicardium - inflammatory process such as sarcoid

• Has decreased early enhancement
• No delayed enhancement

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

• 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

• ASD and absent radius

• 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