Cardiolovascular Imaging Flashcards

1
Q

7 conditions with SMALL HEART

pressure overload and decreased ventricular compliance

A
  1. Aortic stenosis
  2. Arterial HTN
  3. Mitral stenosis
  4. Acute M.I.
  5. Hypertrophic cardiomyopathy
  6. Restrictive cardiomyopathy
  7. Constrictive pericarditis
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2
Q

8 conditions with LARGE HEART

volume overload; myocardial failure

A
  1. Aortic Regurgitation,
  2. Mitral Regurgitation,
  3. Tricuspid Regurgitation,
  4. High output states,
  5. Congestive cardiomyopathy,
  6. Ischemic cardiomyopathy,
  7. Pericardial effusion
  8. Paracardiac mass
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3
Q

MC benign cardiac tumor

“M-L-A LYMPH(manila lymph)”

A

MYXOMA (MC site: Left Atrium)

2nd MC: Lipoma (MC site: right atrium/atrial septum)

MC Malignant (in adults): Angiosarcoma
2nd MC Malignant (in adults): Lymphoma
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4
Q

MC cardiac tumor in children

“ReFeR”

A

RHABDOMYOMA

2nd MC: Fibroma

*MC Malignant: Rhabdomyosarcoma

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5
Q

MC primary malignant cardiac tumor in adult

A

ANGIOSARCOMA

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6
Q

MC primary malignant cardiac tumor in children

A

RHABDOMYOSARCOMA

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7
Q

DeBakey Classification

“BAD”

A

Type I: BOTH ascending and descending aorta
(Stanford A)

Type II: Ascending aorta only
(Stanford A)

Type III: Descending aorta only
(Stanford B)

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8
Q

Most common vascular anomaly

A

Anomalous or Aberrant Right Subclavian Artery

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9
Q

CORONARY ARTERY DOMINANCE:
A. RIGHT Dominant?

B. LEFT Dominant?

C. CO-DOMINANT?

A

CORONARY ARTERY DOMINANCE:
- determined by artery(ies) supplying the
posterior descending artery (PDA) and posterolateral artery (PLA)

A. RIGHT Dominant (85 %):
- RCA supplies both PDA and PLA

B. LEFT Dominant (7.5%):
- LCxA supplies both PDA and PLA

C. CO-DOMINANT (7.5%):

  • RCA supplies PDA
  • LCxA supplies PLA
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10
Q

MC Predisposing factor for AORTIC DISSECTION

A

HYPERTENSION

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11
Q

Most reliable finding for the diagnosis of aortic dissection on MSCT is the __________.

A

presence of an INTIMAL FLAP separating the true and false channels

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12
Q

Most common cause of congestive heart failure in the first day or two of life?

A

hypoplastic left heart syndrome

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13
Q

most common type of dextrocardia

A

mirror image dextrocardia

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14
Q

diverticulum at the base of the aberrant left subclavian artery is called ____________

A

Kommerell diverticulum

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15
Q

Isolated left subclavian artery receives blood from the aorta via retrograde flow through the ipsilateral vertebral artery and hence the term “________”.

A

congenital subclavian steal syndrome

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16
Q

Which cardiac chamber is most commonly affected in idiopathic cardiomyopathy (in swischuck) ?

A

LEFT VENTRICLE

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17
Q

Two forms of idiopathic cardiomyopathy (in swischuck):

  1. restrictive and
  2. congestive cardiomyopathies.

Compare them according to myocardial wall thickness.

“restricTHICK” and “congesTEEEEN (thin)”

A

The term “restrictive” results from the fact that the THICKENED myocardium fosters poor systolic filling of the left ventricle, and the

term “congestive” reflects the fact that the THINNED left ventricular myocardium is ineffective in expulsion of blood from the left ventricle, and passive congestion results.

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18
Q

The most common pericardial tumor noted in childhood, and especially in infancy, is ______. (in swischuck)

A

pericardial teratoma

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19
Q

most common cause of arterial aneurysm in the pediatric age group

A

Mycotic aneurysms secondary to infection

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20
Q

The most common cause of dilated cardiomyopathy is

__________.

A

myocardial ischemia secondary to coronary artery disease

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21
Q

The most common clinical feature of dilated cardiomyopathy is
_________.

A

LV failure

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22
Q

SALIENT VALVULAR LESION OF RHEUMATIC HEART DISEASE

“MS. RHEUMA”

A

MITRAL STENOSIS

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23
Q

typical feature of valvular pulmonic stenosis

A

enlargement of the main and left pulmonary arterial segments

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24
Q

Most often cause of Pulmonary regurgitation

“PuRe PAH-PAH”

A

PULMONARY ARTERIAL HYPERTENSION

“PuRe PAH-PAH”
PUlmonary REgurgitation
Pulmonary Arterial Hypertension (PAH)

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25
Q

major feature of pulmonary regurgitation

A

enlargement of the main pulmonary arterial segment,

central pulmonary arteries, and right ventricle.

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26
Q

major radiographic feature of tricuspid stenosis

A

isolated right atrial enlargement

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27
Q

“Wall-to-wall”

Mnemonic: “T.R. wall”

A

SEVERE TRICUSPID REGURGITATION

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28
Q

most frequent mass within a cardiac chamber

A

thrombus

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29
Q

______ are reported to be the second most common benign cardiac tumor in adults *but may actually be the most common.
(Webb).

A

LIPOMAS

  • If the mass projects into the RIGHT ATRIUM, it is called LIPOMA
  • If the mass is confined to the ATRIAL SEPTUM, it is called LIPOMATOUS HYPERTROPHY
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30
Q

Lipomas are typically located in the ___ or ____.

A

right atrium or atrial septum

31
Q

Primary tumor with the highest frequency of metastatic seeding into the heart

A

MELANOMAS

32
Q

3 tumors that most frequently metastasize to the heart
*but cardiac metastases can arise from almost any malignant tumor in the body.

“MaLaLa”

A
  1. Melanoma
  2. Leukemia
  3. Lymphoma
33
Q

most common intracardiac mass

A

THROMBUS

34
Q

most frequent location of cardiac thrombus

A

LV or left atrium

35
Q

Most frequent etiology of acute pericarditis

A

VIRAL

36
Q

Ninety percent of pericardial cysts are located in the _____.

A

cardiophrenic angles

  • 70% on the right and 20% on the left side
37
Q

Most frequent primary PERICARDIAL tumor

A

MESOTHELIOMA

38
Q

TRUE OR FALSE.

Secondary tumors of the pericardium are far more common than primary pericardial tumors.

A

TRUE

39
Q

most common primary tumors that involve the pericardium

A

Lymphomas, melanomas, lung, and breast carcinomas

40
Q

Acyanotic Congenital Heart Diseases with
NORMAL VASCULARITY

“CAPI”

A
  1. Coarctation of the aorta
  2. Aortic stenosis
  3. Pulmonary stenosis
  4. IAA
41
Q

Expected specific heart chamber enlargement if the shunt occurs at the level of the great vessels
(i.e., patent ductus arteriosus)

“GREAT LEFT”

A

“GREAT LEFT”

  • shunt at GREAT vessel level
  • pure LEFT-side (LEFT ventricle and LEFT atrium) pattern of enlargement
42
Q

Expected specific heart chamber enlargement if it occurs at the ventricular level.

“BiLeVe (believe)”

A

“BiLeVe (believe)”
BI-lateral ventricular and predominant
LE-ft side enlargement
VE-ntricular level

  • biventricular enlargement tends to occur with larger shunts,
    for shunting occurs both during systole and during diastole
43
Q

Expected specific heart chamber enlargement the defect
if it is located at the atrial level

“AtriaRIGHT”

A

“AtriaRIGHT”

  • shunt at the Atrial Level
  • RIGHT atrium and RIGHT ventricle enlargement
  • the left side of the heart is not involved in the resultant abnormal hemodynamics
44
Q

LEFT TO RIGHT SHUNT specific chamber enlargement guide

“GREAT LEFT”; “BiLeVe (believe)”; “AtriaRIGHT”

A

“GREAT LEFT”

  • shunt at GREAT vessel level
  • pure LEFT-side (LEFT ventricle and LEFT atrium) pattern of enlargement

“BiLeVe (believe)”
*shunt at the VEntricular level
- either BIlateral ventricular enlargement or predominant
LEft-side enlargement

“AtriaRIGHT”

  • shunt at the Atrial Level
  • RIGHT atrium and RIGHT ventricle enlargement
45
Q

covers and closes the foramen ovale

A

SEPTUM PRIMUM

46
Q

Fetal communication between the great vessels

aorta and main pulmonary artery

A

DUCTUS ARTERIOSUS

  • while this communication is essential in the fetus, its persistence after birth results in a left-to-right shunt
  • in the full-term infant
  • patent ductus arteriosus closes within a few hours or days after birth.

*in the premature infant,
where hypoxic pulmonary disease is commonplace
- the ductus, being very sensitive to hypoxia, remains open
- premature infant does not have the luxury of the presence of physiologic pulmonary hypertension as exists in the full-term infant

47
Q

Dilated Cardiomyopathy

A

Cardiomegaly - YES
PVH - SOME
LAE - YES
LVE - YES

48
Q

Hypertrophic Cardiomyopathy

A

Cardiomegaly - MILD
PVH - MINORITY
LAE - YES WITH MRI
LVE - END STAGE

49
Q

Restrictive Cardiomyopathy

A

Cardiomegaly - NORMAL
PVH - YES
LAE - YES

50
Q

Regurgitation

A
  • Acute vs chronic
  • Leaky valve/backflow of blood
  • VOLUME OVERLOAD
  • Compensatory mechanism: ECCENTRIC hypertrophy
51
Q

Stenosis

A
  • Chronic
  • Stiff valve/increase in afterload
  • PRESSURE OVERLOAD
  • Compensatory mechanism: CONCENTRIC hypertrophy
52
Q

Most commonly affected coronary artery in

coronary artery fistulas

A

RIGHT CORONARY ARTERY

53
Q

TAPVR TYPES
The common pulmonary vein drains into the these structures:
(According to type)
Type I - _________
Type II - _________
Type III - _________
Type IV - mixture of the first three types

(Mnemonic:”SA-R-S mixture”)

A

TAPVR TYPES
The common pulmonary vein drains into the these structures:
(According to type)
*Type I - supracardiac veins
(via the “vertical vein” on the left aka persistent left SVC)
IA: Superior Vena Cava
IB: Azygos Vein

*Type II - RIGHT ATRIUM
(via the coronary sinus)

*Type III - SYSTEMIC ABDOMINAL VEIN
(Most frequently the portal vein)

*Type IV - mixture of the first three types

(Mnemonic:"SA-R-S mixture")
IA: SVC
IB: Azygos vein
II:   Right atrium
III:  Systemic abdominal vein
IV:  MIXTURE of the first three types
54
Q

Problem in TAPVR type I (“snowman”) anomaly, when the vertical vein is compressed by the pulmonary artery and left bronchus, resulting in a so-called “________”.

A

pulmonary vise syndrome

55
Q

accounts for the upper portion of the snowman in TAPVR Type I

A

resultant connections of the following vessels which form an inverted U-shaped vessel:

common pulmonary vein +
vertical vein (persistent left superior vena cava) +
innominate vein +
(which travels across the mediastinum and empties into the)
superior vena cava.

56
Q

Condition which mimics snowman appearance of TAPVR type I

A

large ventricular septal defect + large thymus gland

57
Q

Condition wherein both great vessels
(Aorta and Pulmonary Artery)
receive blood from the right ventricle

A

“double-outlet right ventricle” abnormalities

58
Q

In double-outlet right ventricle abnormalities,
However, while the AORTA always arises solely from the right ventricle,

the PULMONARY ARTERY may arise from:

  • Double-outlet right ventricle type I - _________
  • Double-outlet right ventricle type II - _________

“DOBLE PuR -I (puri)”
“DOBLE DOBLE -II”

A

In double-outlet right ventricle abnormalities,

the PULMONARY ARTERY may arise from:
*Double-outlet right ventricle type I - RIGHT VENTRICLE alone
*Double-outlet right ventricle type II - BOTH VENTRICLES
(Taussig-Bing)

“DOBLE PuR -I (puri)”
“DOBLE DOBLE -II

59
Q

In TOGA, narrowness of the pedicle is due to the ____.

A

anteroposterior positioning of the aorta and pulmonary artery

60
Q

MC cause of cyanotic congenital heart disease beyond the first 30 days of life

A

Tetralogy of FaIlot

61
Q

Hemodynamically, the critical component of tetralogy of Fallot is _______.

A

pulmonary stenosis

62
Q

most common cause of congestive heart failure in the first day or two of life

A

hypoplastic left heart syndrome

63
Q

Etiology of BEER DRINKER’s CARDIOMYOPATHY

A

COBALT

64
Q

AGATSTON SCORING

A

0-10 Low risk
11-100 Moderate risk
101-400 Moderate high risk
>400 Severe

65
Q

Chamber location of Lipoma, Angiosarcoma and Lymphoma

LALakers RAcks (Rocks!) \m/

A

LIPOMA
ANGIOSARCOMA
LYMPHOMA

All are located in the Right Atrium

66
Q

Describe the aortic findings of the following:
A. ASD
B. VSD
C. PDA

A

A. ASD - diminutive aorta
B. VSD - aorta is unremarkable
C. PDA - aorta is prominent

67
Q

Two Congenital Heart diseases with right-sided aortic arch

A
  1. TOF

2. Persistent Truncus Arteriosus

68
Q

MC VALVULOPATHY

A

AORTIC STENOSIS

69
Q

MC Aortic Stenosis type

A

VALVULAR Aortic Stenosis

70
Q

MC cause of RESTRICTIVE CARDIOMYOPATHY

A

SYSTEMIC AMYLOIDOSIS

71
Q

MC CARDIAC MASS

A

THROMBUS

72
Q

MC BENIGN CARDIAC TUMOR IN ADULTS

A

MYXOMA

73
Q

2nd MC benign cardiac tumor in adults

A

LIPOMA

74
Q

MC cause of aortic dissection in :
A. Older patients
B. Younger patients

A

A. Older patients
- HYPERTENSION

B. Younger patients
- CONNECTIVE TISSUE DISORDER
(Marfan’s Syndrome, Bicuspid Aortic Valve)