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2014-10-22 11:23:08
Cardiac radiology

Review of cardiac radiology
Show Answers:

  1. What structures does the right atrium receive blood from?


    Coronary sinus
  2. What structure does the ductus arteriosus become when it closes?
    Ligamentum arteriosum
  3. What is the structure that forms as a result of the junction between the sinus venosus and the primitive right atrium?
    Crista terminalis
  4. How can LV enlargement be assessed on the lateral plain film?
    Extension greater than 1.8 cm posterior to border of IVC
  5. What is the first manifestation of congestive heart failure on a radiograph?
    Cephalization of blood flow - Perivascular edema in lower lobes > decreased compliance > flow directed upwards
  6. What are chest radiographic findings that are associated with Down's syndrome?
    Hypersegmentation of the sternum (more than 5 segments)

    11 or fewer ribs

    Cardiomegaly (endocardial cushion defect)
  7. What is the pathophysiology of inferior rib notching seen in things like aortic co-arctation?
    Increased collateral circulation via intercostal arteries
  8. What determines the sidedness of dominance of the coronary circulation?
    The side that gives rise to the posterior descending artery (PDA)
  9. What is the difference between aortic coarctation and aortic pseudo-coarctation?
    Pseudocoarctation - excessive length of descending aorta

    • No pressure gradient
    • No rib notching (no need for collaterals)
  10. Ebstein's anomaly

    Abnormal tricuspid valve displaced downward into right ventricle > right heart enlargement
  11. What is the most common malignant PRIMARY cardiac tumor?
  12. How does infarcted myocardium behave with delayed contrast enhancement?
    Normal myocardium - contrast washes in and out quickly

    Abnormal myocardium - holds onto contrast
  13. What separates the inflow and outflow portions of the right ventricle?
    Crista supraventricularis
  14. What are complications of congenital/partial absence of the pericardium?
    Generally asymptomatic

    • Occasionally can cause herniation
  15. Left atrial enlargement

    • Double density sign
    • Splaying of carina
  16. What is the characteristic defect in total/partial anomalous pulmonary venous return?
    Pulmonary blood flow going into the right atrium (directly/indirectly) instead of the left atrium.
  17. What are characteristic findings in Loeys Dietz syndrome?
    Craniofacial abnormalities

    Arterial aneurysms/tortuosity (particularly aortic root, more pronounced vascular involvement versus Marfan's syndrome)
  18. What is the difference in enhancement between myocardial infarction and myocarditis?
    Myocarditis - does not have subendocardial enhancement - typically mid myocardial or sub EPI cardial enhancement
  19. What is the most common primary cardiac tumor in adults versus children?
    Adults - myxoma

    Children - rhabdomyosarcoma
  20. What is the most common location for a cardiac myxoma?
    Most commonly seen in left atrium
  21. What are the sinuses of Valsalva?
    3 small dilatations of the aortic root, thought to be helpful in allowing aortic leaflets to open without occluding coronaries. 

    Right coronary sinus, left coronary sinus and non-coronary sinus
  22. Bland White Garland Syndrome

    Anomalous origin of left coronary artery from pulmonary artery
  23. Scimitar syndrome

    Anomalous venous return from right heart to the systemic circulation instead of the left atrium.
  24. What is the most common restrictive cardiomyopathy in the United States?
    Cardiac amyloidosis
  25. Pulmonary stenosis - right ventricular outflow tract obstruction with post stenotic dilatation of main pulmonary artery and preferential flow to left pulmonary artery
    • Marfan's syndrome
    • - Annuloaortic ectasia
    • - Pectus deformity (excavatum)
    • - Scoliosis
    • - Dural ectasia