Cardiac Flashcards
What are the differentials for cyanotic cardiac defects?
- Tetralogy of Fallot
- Transposition of great vessels
- Tricuspid atresia
- Total anomalous pulmonary venous return
- Truncus arterosus
- Taussig-Bing
- Tingle (Single ventricle)
- Eisenmenger’s complex
What are the differentials for acyanotic cardiac defects?
- Patent ductus arteriosus
- Inter-atrial septal defects
- Ventricular septal defects
- Persistent common atrioventricular canal
- Pulmonic stenosis
- Aortic stenosis
- Aortic coarctation
- Endocardial cushion defect
- Lutembacher’s syndrome
What is the tetrology associated with Tetralogy of Fallot?
- Pulmonic stenosis
- High interventricular sepatal defect
- Aorta overriding the ventricular septum
- Hypertrophic right ventricle
Tetrology of Fallot is which kind of shunt?
Right-to-left (right ventricle into aorta)
What other anomalies can occur with Tetralogy of Fallot?
a. patent foramen ovale (M/C)
b. true atrial septal defect
c. right sided aortic arch
Is there an increase or decrease in pulmonary vascularity in Tetralogy of Fallot?
Decrease – decreased size of vessels (therefore, smaller hilum)
What is the cardiac radiological sign associated with Tetralogy of Fallot?
Boot-shaped heart
What is the Trilogy of Fallot?
a. patent foramen ovale
b. pulmonary valve stenosis
c. right ventricular hypertrophy
An egg-shaped heart is suggestive of which congenital condition?
Transposition of the great vessels
Are the pulmonary vessels increased, decreased or normal in transposition of the great vessels?
Increased
In order for survival, what other anomaly must also be present with an atretic tricuspid valve?
atrial septal defect
Tricuspid atresia can be present with and without pulmonary stenosis. What is the pulmonary vascularity like when there is stenosis and when there is not?
Choose between increased, decreased or normal.
W/ stenosis –> decreased
W/out stenosis –> increased or normal
With tricuspid atresia without pulmonary stenosis, what other anomaly is also commonly present other than atrial septal defect?
Transposition of the great vessels.
What is an Ebstein’s anomaly?
Downward displacement of tricuspid valve into right ventricle.
Upper portion of right ventricle is incorporated into right atrium.
Which additional anomaly can present with an Ebstein’s anomaly resulting in a right to left shunt?
Atrial septal defect
What is the radiological shape of the heart in an Ebstein’s anomaly?
Box-shaped
What is the M/C location where a TOTAL anomalous pulmonary venous return drains into?
What are some other locations?
M/C left brachiocephalic vein (innominate vein).
Other:
- coronary sinus
- right atrium
- R/L superior vena cava
- portal vein
What is the M/C cardiac anomaly? What is the 2nd?
1st = Atrial septal defect 2nd = ventral septal defect
What is the M/C location for a PARTIAL anomalous pulmonary venous return?
Right atrium
What is the scimitar syndrome?
Hypoplasia of right lung + anomalous right pulmonary venous return into the IVC
What is Taussig-Bing?
Transposition of aorta arising from right ventricle + pulmonary artery overrides ventricular septum + ventricular septal defect
What is the Eisenmenger complex?
A left-to-right shunt over time becomes a right-to-left shunt d/t left ventricular failure.
What is the main cause for why a left-to-right shunt converts into a right-to-left shunt?
Pulmonary hypertension
Are the pulmonary vessels increased, decreased or normal in patent ductus arteriosus?
Increased
In which direction is the shunt in a patent ductus arteriosus?
Left-to-right
In which direction is the shunt in a atrial septal defect?
Left-to-right
What 4 left-to-right shunts cause an increase in the pulmonary artery?
1) Atrial septal defect
2) Ventricular septal defect
3) Patent ductus arteriosus
4) Lutembacher’s syndrome
Which condition consists of atrial septal defect + congenital or acquired mitral stenosis + increased pulmonary artery?
Lutembacher’s syndrome
What is a atrioventricularis communis?
Low atrial septal defect + high ventricular septal defect + cleft in mitral & tricuspid valves
What is the M/C associated abnormality with coarctation of the aorta?
Bicuspid aortic valve (85%)
Rib notching seen with aortic coarctation is M/C seen at which levels and what side?
4-8th inferior ribs; bilateral but asymmetric
Where the M/C site of constriction in aortic coarctation?
At or distal to ductus arteriosus.
What sign is on the esophagus on a barium swallow when aortic coarctation is present?
Reverse 3 sign (aka E sign)
- as opposed to the figure-3 sign seen on the plain film involving the aorta.
What is endocardial cushion defect?
Large hole in center of heart where wall/septum joins upper and lower chambers of the heart. Tricuspid and mitral valves may be one large valve.
What is the M/C/C of mitral stenosis?
Rheumatic fever
What is the M/C/C for aortic stenosis?
Rheumatic heart disease
What is the snowman sign?
Seen in total anomalous pulmonary venous return - the supracardiac (SVC) variant.
