cardiac cases mr Flashcards
left ventricular aneurysm and thrombus
lipomatous hypertrophy of the intra-atrial septum
notice sparing of the fossa ovalis
Lipomatous hypertrophy of the interatrial septum is a common incidental finding (2-3% of the population) seen on CT, echocardiography, and MR. It occurs when there is a benign, unencapsulated accumulation of fetal brown fat, hypertrophied myocytes, myocardial fibers, and fibrosis within the interatrial septum. This process spares the fossa ovalis, which is a good way to differentiate it from other potentially fatty masses such as a lipoma. This sparing of the fossa ovalis creates the “dumbbell” shape that is often seen. Because of the presence of brown fat, it can show increased uptake of FDG-PET imaging.
Ebstein anomaly
Classically, Ebstein anomaly presents in early life with massive cardiomegaly and cyanosis. However, there is a wide spectrum of disease with some patients being asymptomatic throughout life. If not detected early in life, many patients will develop chronic right heart failure without treatment. Tricuspid valve replacement or reconstruction is the definitive treatment, although Glenn and Fontan procedures can be used early in life to bypass the right heart.
dilated vents, low EF, mid myocardial enhancement
Dilated cardiomyopathy is the most common reason for heart transplantation in the United States. Delayed myocardial enhancement is seen only in approximately half of patients with dilated cardiomyopathies, so the absence of enhancement does not exclude the diagnosis. In cases where enhancement is present, it will be mid-myocardial in distribution. There are over 40 identified causes of a dilated cardiomyopathy but many cases are classified as idiopathic.
History of pulmonary disease
•The delayed enhancement is secondary to fibrosis from granuloma formation in cardiac sarcoidosis. It can be diffuse, patchy, or linear and can involve any region of the heart.
LCx infarct
subendocardial delayed gad enhancement
acute or chronic
Acute MI 2/2 to microvascular obstruction (never chronic)
POOR prognostic finding
setpal bounce on SSFP cine
constrictive pericarditis
most common cause: iatrogenic (CABG or radiation)
“bounce” of septum is most pronounced during inspiration
normal pericardial thickness
normal pericardial thickness < 4 mm
dilated cardiomyopathy (septal mid wall enhancement)
Sarcoidosis
fibroma
myxoma
lipoma
LV thrombus
