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C & R II - wk1 > cardiac radiology > Flashcards

cardiac radiology Flashcards

1
Q

what does left atrial enlargement look like on lateral x-ray

dog

A
  • straight caudodorsal margin (loss of caudal waist)
  • bulging of the cardiac contour at 12-2 o’clock
  • increased height
  • dorsal elevation +/- compression of the caudal mainstem bronchi
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2
Q

what does left atrial enlargement look like on DV/VD

dog

A
  • double density superimposed on cardiac silhouette (bulge between 2-3 o’clock: left auricular enlargement
  • widened angle between the caudal mainstem bronchi
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3
Q

what does left atrial enlargement look like on lateral x-ray

cat

A
  • more difficult to identify
  • widening of the heart base
  • slight buldging or rounding of caudal contour
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3
Q

what does left atrial enlargement look like on DV/VD

cat

A
  • left atrial bulge: 2-3 o’clock, but may extend further cranial
  • “valentine heart” shape: severe left OR left and right atrial enlargement
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4
Q

what does left ventricular enlargement look like on lateral

A
  • tall cardiac silhouette
  • dorsal tracheal displacement
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5
Q

what does left ventricular englargement look like -DV/VD

A
  • elongaeted cardiac silhouette
  • rounded left heart
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6
Q

what does right atrial enlargement look like -lateral and VD

A
  • rounded contour: 9-11 o’clock on both lateral and VD
  • not as common
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7
Q

what does right ventricular enlargement look like - lateral

A
  • rounded cranial heart: 5-9 o’clock
  • right heart > 2/3 of the cardiac silhouette: wide heart
  • increased cardiosternal contrast: may be seen in some normal dogs (barrel chested)
  • caudodorsal tipping of apex
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8
Q

what does right ventricular enlargement look like -VD

A
  • rounding of right heart: 5-9 o’clock
  • reverse D shape
  • may displace the apex to the left (false impression of left-sided cardiomegaly)
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9
Q

what does microcardia look like

small heart

A
  • narrow, pointed heart
  • apexx may lose contac with sternum
  • pulmonary arteries and veins may be small
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10
Q

what are 3 differential diagnoses of microcardia

A
  • hypovolemia (shock)
  • hypoadrenocortism (addison’s disease)
  • constrictive pericarditis (rare)
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11
Q

pulmonary artery and vein diameter

A
  • approx. equal in size (artery ~ vein)
  • < width of the proximal 1/3 of the 4th rib (lateral)
  • ~ width of the 9th rib where it crosses (VD)
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12
Q

caudal vena cava diameter

A
  • variable (respiration, cardiac cycle)
  • < 1.5x diameter of the aorta (~1x)
  • < length of T5
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13
Q

what are the differential diagnoses of an enlarged heart

A
  • cats: age-related (aortic arch)
  • patent ductus ateriosus
  • post-stenotic dilation: subaortic stenosis
  • aortic aneurysm (very rare)
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14
Q

what are the differential diagnoses for an enlarged caudal vena cava

A
  • right heart failure
  • obstruction of caudal vena cava or right atrium (caval syndrom - dirofilariasis, blood clot, mass)
  • normal variation (respiration, cardiac cycle, evaluate on all views)
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15
Q

what are the differential diagnoses of enlarged main pulmonary artery

A
  • post-stenotic dilation (pulmonic stenosis)
  • pulmonary hypertension
  • dirofilariasis or angiostrongylosis
  • left to right shunt (PDA, ASD, VSD)
  • fake out (VD proj, rotated proj, cardiac cycle - systole)
16
Q

what are the differential diagnosis of enlarged pulmonary arteries

A
  • dirofilariasis (pulmonary arteries often also tortuous and blunted)
  • pulmonary hypertension
  • pulmonary thromboembolism (PTE)
17
Q

what are the differential diagnoses of enlarged pulmonary veins

A
  • left heart failure (may not be enlarged if the patient received diruetics)
  • fluid/volume overload (relative vs absolute)
  • left atrial obstuction
18
Q

what are the differential diagnosis for enlarged pulmonary arteries and veins

A
  • left to right shunts
  • pulmonary congestion (fluid volume overload, left heart failure - cats)
19
Q

what are the differential diagnosis for small pulmonary arteries and veins

A

pulmonary hypoperfusion

  • hypovolemia
  • right to left shunts
  • pulmonic stenosis
  • pulmonary thromboembolism
  • decreased cardiac output (pericardial effusion with tamponade, restrictive pericarditis, right heart failure)
20
Q

what are radiographic signs of left heart failure

A
  • enlarged left heart
  • pulmonary venous congestion (enlarged pulmonary veins; cats - +/- enlarged pulmonary arteries)
  • pulmonary edema
  • interstitial to alveolar pulmonary pattern
  • dogs: perihilar, caudodorsal (more severe in right caudal lobe than left, DCM: ocassionally ventral peripheral alveolar pattern)
  • cats: patchy distribution
  • cats: +/- pleural effusion
21
Q

what does left heart failure look like

dog

A
  • enlarged left atrium and ventricle
  • enlarged pulmonary veins
  • caudodorsal alveolar pattern (R>L)
22
Q

what does left heart failure look lik

cat

A
  • left sided cardiomegdally
  • round margins
  • tall
  • buldge in LA (lateral
  • VD - widening at LA & RA
  • “valentine heart”
  • pulmonary pattern too severe to see vasculature
  • pulmonary edema w/ patchy distribution
23
Q

what does pleural effusion look like with left sided heart failure

cats

A
  • retraction of lung lobes from the body wall
  • pleural fissure lines
  • dont see pleural effusion with dogs
24
Q

what does right heart failure look like

A
  • enlarged right heart
  • enlarged caudal vena cava
  • hepatomegaly (congestion)
  • adcites
  • pleural effusion
25
Q

what is degenerative valve disease (valvular endocardiosis)

A
  • older small breed dogs
  • valvular degeneration (regugitation -> volume overload)
  • mitral valve disease (LA enlargement, LV enlargement, LH failure)
  • tricuspid valve disease (RA enlargement, RV enlargement, RH failure)
26
Q

what does degenerative mitral valve disease look like

A
  • enlarged left atrium & ventricle
  • left heart failure (enlarged pulmonary veins, caudodorsal alveolar pattern, R>L)
27
Q

cardiomyopathy in dogs

large breed dogs

A

dilated cardiomyopathy

  • generalized cardiomegaly
  • left atrial enlargemlent
  • +/- heart failure
  • left-sided failure more common
28
Q

what does dilated cardiomyopthy look like

dogs

A
  • left atrial (+/- ventricular) enlargement
  • diffuse interstitial pattern, ventral alveolar regions
29
Q

cardiomyopathy in cats

A

hypertrophic cardiomyopathy

  • also restrictive, dilated, unclassified
  • LA & LV enlargement
  • “valentine” shape
  • +/- heart failure - right-sided cardiomegaly and heart failure less common
30
Q
A
30
Q

what does cardiomyopathy look like in cats

A
  • left atrial & ventricular enlargement
  • left heart failure - patchy alveolar pattern
31
Q

heartworm (dirofilariasis) progression of dx

A
  • pulmonary artieries are enlarged, tortous and blunted (R caudal lobar artery affected first)
  • enlarged main pulmonary artery
  • R sided cardiomegaly (cor pulmonale - 2nd to pulmonary hypertension)
  • enlarged caudal vena cava (caval syndrom)
  • R heart failure
  • bronchial pulmonary pattern, multifocal alveolar pulmonary pattern (pneumonitis, thromboembolism)
32
Q

what does heartworm look like

A
  • enlarged, tortuous, blunted pulmonary arteries
  • enlarged main pulmonary artery
  • right ventriculomegaly
  • diffuse bronchial pattern, patchy interstitial to alveolar pattern
33
Q

what does patent ductus arteriosis (PDA) look like

A

enlarged:

  • aortic arch
  • left atrium/auricle (+ventricle)
  • main pulmonary artery
  • pulmonary artereies and veins (vascular pattern)

triad (triple bump) seen on VD

34
Q

what are causes of pericardial effusion in dogs

A
  • neoplasia (hemangiosarcoma, heart base tumor, mesothelioma)
  • idiopathic
  • congestive heart failure (right sided)
  • left atrial rupture
35
Q

what are causes of pericardial effusion in cats

A
  • congestive heart failure (left or right sided)
  • feline infectious peritonitis
  • lymphoma
36
Q

what does pericardial effusion look like

A
  • large round (globoid) cardiac silhouette (on BOTH lateral and VD)
  • sharp outline of the cardiac silhouette (no motion artifact from heart beating)
  • cardiac tamponade (small pulmonary vasculature, r sided heart failure)

C & R II - wk1 (13 decks)

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