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cardiac [2017/07/07 18:30] (current)
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 +====== 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
cardiac.txt ยท Last modified: 2017/07/07 18:30 (external edit)