cardiac
Table of Contents
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
dokuwiki\Exception\FatalException: Allowed memory size of 134217728 bytes exhausted (tried to allocate 20480 bytes)
An unforeseen error has occured. This is most likely a bug somewhere. It might be a problem in the authplain plugin.
More info has been written to the DokuWiki error log.