CARDIAC Section 4: Great Vessels Flashcards
The most common variant in branching of the great vessles?
Bovine Arch
Describe the Bovine arch
The brachiocephalic artery and left common carotid artery arise from a common origin.
The terminology right arch / left arch is described based on what?
Aortic arch’s relationship to the trachea
When 1say Right Arch with Mirror Branching, You say?
Congenital Heart
There are 5 types of right arches, but only two are worth knowing. What are they?
Abberent Left and Mirror Branching
Identify this arch anomaly. What cardiac anomaly is this type associated?
Descibe
Mirror Image. Associated with congenital heart disease specially TOF
Identify the arch anomaly and describe
Originating from the Back of the Arch
I f there is a mirror image right arch, then 90% will have?
TOF (6% Truncus)
Percentage if the person has Truncus, then they have a mirror image right arch
33% Mirror image (TOF 25%)
The last branch of the Right Arch with aberrant left Subclavian
Left subclavian artery.
What completes the ring in the Right Arch with Aberrant Left subclavian encircling the trachea?
Ligamentum arteriosum (on the left)
Most common arch anomaly.
Left Arch Aberrant Right Subclavian
What is associated with the most common arch anomaly?
Why?
Dysphagia Lusoria
RSCA passes posterior to the esophagus
Identify.
Describ
Diverticulum of Kommerell
origin of the RSCA may be dilated
The most common vascular ring
Double Aortic Arch
What are the symptoms of Double aortic arch and when does it start?
tracheal compression and/or difficulty swallowing - may begin at birth
What is Subclavean Steal phenomenon?
Stenosis and/or occlusion of the proximal subclavian with retrograde flow in the ipsilateral vertebral artery.
What is Subclavean Steal Syndrome?
Stenosis and/or occlusion of the proximal subclavian artery with retrograde flow in the ipsilateral vertebral artery AND associated cerebral ischemic symptoms.
When does reversal of flow happen in the vertebral artery in the setting of Subclavian Steal?
If the level of stenosis and/or occlusion is proximal to the vertebral artery resulting in the theft of blood from the posterior circulation.
When the u?pper limb is excecised, blood i sdiverte away from the brain to the arm resulting to cerebral symptoms (dizziness, syncope), and these symptoms depende on the integrity of what vessel?
Collateral intracranial flow (PCOMs)
Subclavian Steal is almost always caused by?
Atherosclerosis (98%) - ADULT
OTher causes include:
Takayasu Arteritis - TEENS
Radiation, Preductal Aortic Coarctation, and Blalock- Taussig Shunt.
Identify
Subclavian Steal
