Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ST2 Radiology > Cardiac > Flashcards

Cardiac Flashcards

1
Q

how can ‘stress’ be initiated in a myocardial perfusion study

A

physical - treadmill
pharmacologic-adrenergic (dobutamine)
pharmacologic - vasodilatory (adenosine, dipyridamole, regadenoson)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the gold standard for evaluating cardiac viability ?

A

F-18 FDG PET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does thallium perfusion study work to investigate myocardial perfusion

A

thallium is only taken up in viable myocardial tissue, therefore during stress - if the tissue is ischaemic it won’t be taken up, but during rest it will revascularise and be taken up again .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when would you use a pharmacological stress ?

A

patients who can’t exercise, left bundle branch block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does dipridamole work ?

A

caused endogenous adenosine to acculumate - this cause vasodilation of the coronary arteries - therefore if a coronary artery has critical stenosis, it won’t be able to relax and therefore have relative perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what must be held before dipyridamole is given ?

A

caffeine and theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the reversal agent to dipyridamole and adenosine ?

A

aminophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when is a vasodilator contraindicated ?

A

COPD, severe asthma, recent caffeine ?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what would you give if a vasodilator is contraindicated ?

A

dobutamine ( B-agonist that increases myocardial oxygen demand)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does myocardial stunning indicate and what is it ?

A

significant obstructive coronary artery disease
Myocardial stunning is when an acute transient myocardial ischaemic event results in a prolonged wall motion abnormality which eventually resolves.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how can you assess motion artefact on a cardiac study ?

A

sinogram - will show horizontal lines at the areas of movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is hibernating myocardium :

A

viable but hypo perfused myocardium due to severe chronic schema, which may benefit from revascularization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is stunned myocardium

A

delayed recovery of contractile function despite reperfusion after a transient ischaemic insult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the gold standard for evaluating myocardial viability and hibernation /

A

FDG - PET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the FDG Pet uptake known as in a hibernating myocardium ?

A

Increased - mismatch

Low perfusion and normal/increased metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is amyloidosis ?

A

extracellular deposition of insoluble proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what does left atrial enlargement and cardiomegaly indicate with regards to cardiac valve disease

A

mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what does left atrial enlargement and a normal sized heart indicate ?

A

mitral stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what does enlarged aorta and cardiomegaly indicate ?

A

aortic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what does an enlarged aorta and normal sized heart indicate ?

A

aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does the double density sign represent ? q

A

enlarged left atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is a coronary artery CT angiogram the first line test for ?

A

patients with acute chest pain, in low to intermediate risk pateitns without known CAD - with normal cardiac enzymes and non-ischemic egg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the luminal diameter of a coronary artery ?

A

3mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

if a coronary artery arises from the pulmonary artery is it benign or malignant ?

A

malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

which coronary artery courses are malignant ?

A

inter arterial course - between the aorta and pulmonary artery
intramural course - within the aortic wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is myocardial bridging ?

A

band of myocardium overlying a segment of a coronary artery most commonly seen in the mid or distal LAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the agatston score ?

A

the total calcium In the coronary tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what reporting classification is used to standardised cardiac reports ?

A

CAD-RADS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

If there is a coronary artery stenosis of 25-49% what is recommended ?

A

preventative therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

if there is a cadres 70-100% what is recommended ?

A

function tests, invasive coronary angiography and consider revascularisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what sings indicate a high risk plaque (increased risk of ACS)

A

low attenuation (<30)
Spotty calcification
Napkin ring (Low attenuation core and higher outer ring)
Postive remodeeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what are the main complication following coronary artery stenting ?

A

stent thrombosis and in-stent restenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the preferred diagnostic modality to assess coronary bypass grafts ?

A

cardiac catherterisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are the two most common causes of coronary artery dilatation ?

A

atherscerlosis and Kawasaki disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

In cardiac MRI what is the spin echo sequence used for?

A

high spatial resolution but slow to obtain - good for anatomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

in cardiac MRI what is the spoiled gradient recalled echo used for ?

A

faster but more suseptible to metal artefacts - used for quantitive measurements, perfusion and angiography

37
Q

what is the balanced stead-state free precession gradient echos used for ?

A

very fast - high temporal resolution with good contrast between myocardium and blood pool. therefore looks at wall motion, valve function and volume quantification

38
Q

what is the gold standard for evaluating LV volume, EF and mass ?

A

MRI Cardiac

39
Q

what does a double IR technique used for ?

A

make blood black

40
Q

what is a triple IR technique used for ?

A

make blood and fat black

41
Q

what is first pass contrast enhanced perfusion MRI used for ?

A

evaluate myocardial perfusion. - normal myocardium enhances normally, decreased perfusion will be hypo enhancing.

42
Q

do malignant masses have a more avid or less avid first pass perfusion?

A

more avid

43
Q

what does myocardial tagging involve, and what is It used for ?

A

grid is placed over the myocardial tissue or mass. looks for movement by assessing how the grid lines change their shape

44
Q

what does a subendocaridal late gadolinium enhancement mean ?

A

infarction
- as the subendocardium is most susceptible to iscahemia, and is always in a vascular teritory

45
Q

what group of patients is circumfrential subendocarial late gadolinium enhancement seen ?

A

chronic cocain users

46
Q

what does transmural LGE represent ?

A

nonviable scar

47
Q

what are the classical findings of chugs myocarditis ?

A

Chagas - protozoan disease caused by trypanosome Cruzi .

Causes epicardial or mesocardial LGE specifically involving the apex

48
Q

what might sarcoidosis of the heart look like on cardiac MRI ?

A

present with arrhtymias, restrictive cardiomyopathy.

Mesocardial or subepicardial LGE in a nodular or patchy pattern.

49
Q

what would dilated cardiomyopathy look like on cardiac MRI

A

Dffused mesocardial LGE

50
Q

what are non-iscahemic causes of subendocardial delayed enhancement ?

A

Amyloidosis - extracellular deposition of glycoprotein, causing biventricular myocardial thickening

Cardiac transplant

hypereosinophillic syndrome: eosinophilic infiltration of multiple organs

51
Q

on a stress cardiac MRI, what does and oedematous region without LGE represent ?

A

myocardium at risk for ischaemia

52
Q

what is the classic radiological finding of an acute papillary rupture post cardiac MI ?

A

acute pulmonary oedema in the right upper lobe due to acute mitral regurgitation

53
Q

what are true LV aneurysms associated with.

A

occlusion of the LAD

54
Q

what is a true LV aneurysm ?

A

focal out pouching affecting all layers of the muscular wall. usually wall thinning. No risk of rupture. Get medial management

55
Q

how are cardiac pseudoaenurysms managed ?

A

surgical closure due to high risk of impending rupture

56
Q

what is dressers syndrome ?

A

subacute immune-mediated pericarditis which occurs 2-6 weeks post MI. pericardial and pleural effusions

57
Q

what is takotsubo ?

A

broken heart syndrome
High levels of stress causes reversible cardiomyopathy - ballooning of the cardiac apex, that looks like the Japanese lobster pot)
no coronary stenosis

58
Q

what is arrhytogenic cardiomyopathy and what do patients require ?

A

fibrofatty replacement of the ventricular heart muscle - usually affecting the right ventricle. Patients at high risk of arrhtymias - therefore need an ICD

59
Q

what is the most common cardiomyopathy ?

A

HCM - hypertrophic cardiomyopathy

60
Q

what is hypertrophic cardiomyopathy :

A

AD - left ventricular myocardial thickening (diffuse or focal )

61
Q

what does idiopathic hypertrophic sub aortic stenosis cause ? how big does it have to be to require an ICD ?

A

septal hypertrophy - resulting in left ventricular outflow tract obstruction. > 30mm needs an ICD.
more than 15mm indicate disease

62
Q

what is restrictive cardiomyopathy ?

A

small, stiff thickening ventricles that impair diastolic (relaxing) filling.

63
Q

what are the causes of restrictive cardiomyopathy ?

A

idiopathic, sarcoidosis, haemochromatosis, hyperoesinophillic syndrome and amyloidodid

64
Q

what is dilated cardiomyopathy characterised by ?

A

diffuse cardiac chamber enlargement with impaired systolic function - so can’t pump the blood out properly

65
Q

what further investigation is recommended in someone with a new diagnosis of dilated cardiomyopathy ?

A

catheter angiography

66
Q

what might cause acquired bicuspid aortic valve

A

rheumatic fever

67
Q

what are the causes of valvular aortic stenosis ?

A

congenital bicuspid aortic valve, age, rheumatic heart disease

68
Q

what causes supra-valvular aortic stenosis ?

A

congenital abnormality or Williams syndrome

69
Q

what causes subvalvular aortic stenosis

A

fibrous membrane beneath the aortic cusps, hypertrophic cardiomyopathy, narrowing of the LV outlet

70
Q

does aortic stenosis cause heart enlargement ?

A

no, causes left ventricular hypertrophy but not and enlarged heart

71
Q

what defines s a severe aortic stenosis ?

A

valvular area <1cm and a pressure gradient >40mmhg

72
Q

does aortic regugitation cause an enlarged heart ?

A

yes

73
Q

what is the most common cause of mitral stenosis ?

A

rheumatic heart disease

74
Q

which part of the heart does mitral stenosis affect ?

A

causes left atrial enlargement, but no cardiomegaly

75
Q

what is an abnormal thickness for the pericardium ?

A

> 4mm

76
Q

where do most pericardial metastasis come from

A

Breast and lung

77
Q

what is the most common primary pericardial tumour ?

A

mesothelioma

78
Q

where do most pericardial cysts occur ?

A

right cardiophrenic angle

79
Q

what is the most common benign primary cardiac tumour in adults ?

A

myxoma

80
Q

where do most myxomas arise ?

A

left atirum - usually attached to the inter-atrial septum

81
Q

what do myxomas look like ?

A

T1 looks similar to cardiac mucscl
t2 is hyperintense
calcification and blood products from bleeds are common

82
Q

where do cardiac lipomas most commonly occur ?

A

in the right atrium - they follow fat signal on all MRI sequences

83
Q

what does lipomatous hypertrophy of the interatrial septum look like ?

A

proliferation of fatty deposits within the inter-atrial septum but sparing the fossa ovals so looks like a dumbbell.

84
Q

where do papillary fibroelastomas occur ?

A

cardiac valves - usually on the aortic valve.

85
Q

what is the most common malignant primary cardiac tumours ?

A

sarcomas

86
Q

where do angiosarcomas usually affect ?

A

the right atrium

87
Q

where do cardiac myxomas tend to occur ?

A

attached to the septum. by a stlak

88
Q

What is Carney syndrome

A

atrial myxoma, facial/buccal pigmentation, sertoli tumours of the testis

ST2 Radiology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions