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ICA > Congenital heart disease > Flashcards

Congenital heart disease Flashcards

1
Q

What is the MC congenital heart disease presenting in adult patients?

A

Atrial septal defect which is an opening between atria

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2
Q

What is the tetralogy of fallot?

A

obstructed pulmonary outflow
ventricular septal defect
Rt ventricular hypertrophy
aorta over riding interventricular septum

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3
Q

What are the S/S of congestive heart failure?

A 
Kerley's lines
Enlarged heart
Enlarged superior vena cava
Pleural effusion
Pulmonary edema 
Cephalization of blood flow
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4
Q

what are Kerley’s lines?

A

A,B,C
distension of interstitial tissues due to pulmonary fluid overload
Kerley B lines are asso w/ CHF & are analogues to Sharpeys fibers of periosteum

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5
Q

What are the signs of pulmonary edema asso w/ CHF?

A

“Batwing”
“Butterfly”
“perihilar haze”

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6
Q

What is the mechanism of failure of LEFT sided heart failure?

A

congests pulmonary tissues

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7
Q

What is the mechanism of failure of RIGHT sided heart failure?

A

congests body tissues

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8
Q

What are the S/S of CHF?

A

Enlarged neck veins, pitting edema, shortness of breath, chronic non-productive cough, nocturia, enlarged liver

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9
Q

What is cephalization?

A

vessels in the upper chest at more prominent as a manifestation of pulmonary venous hypertension

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10
Q

What causes hilar haziness?

A

enlarged pulmonary veins with perivascular fluid collection leads to full, hazy hilum

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11
Q

Describe Kerley B lines

A

Early phase of CHF
2-3 cm long in bases perpendicular to pleural surface
due to increased lymphatic flow & fluid in interstitium

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12
Q

What happens during late phase CHF?

A

basal congestion, pulmonary edema which shows bilateral diffuse alveolar findings with butterfly distribution, air bronchograms, & soft coalescing densities

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13
Q

What is pleural effusion?

A

Free (gravity dependent) or loculated (secondary to fibrosis) collections of transudate, exudate, blood or chyle in pleural space

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14
Q

Where in a normal lung is the horizontal fissure located?

A

in the middle of the lung; if raised, indicates atelectasis

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15
Q

What is pulmonary edema?

A

fluid accumulation in the extravascular space; due to increased venous/ capillary pressure

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16
Q

What are causes of pulmonary edema?

A

MC left sided heart failure
capillary permeability
renal failure
obstructed lymph channels

17
Q

What are the radiographic signs of pulmonary edema?

A

radiodense septal lines (Kerleys ABC)
hilar haze
peribronchiovascular haze
subpleural edema

18
Q

What are the 3 types of Kerley’s lines?

A

A- apex: long straight lines in upper lung b/w hilum & pleura
B- Base: short straight lines in lower periphery. perpendicular to pleural surface
C-Center: consist of fine network of interlacing lines

19
Q

How does “butterfly”, “sunburst”, “batwing” sign appear on radiograph?

A

radiodense lines radiating from hilum

20
Q

How does air bronchiogram appear on radiograph?

A

radiolucent shadows thru consolidation

21
Q

What creates a pulmonary thromboembolism?

A

a clot forms from the sticky nature of blood in lower extremity due to decreased pressure

22
Q

Where do thromboemboli arise from?

A

venous circulation, bone marrow, amniotic fluid, etc

Most from deep veins of lower extremity

23
Q

What is the difference between a thrombo and an embolism?

A 
thrombo = stationary clot
embolism = moving clot
24
Q

What are some radiographic findings of pulmonary thromboembolism?

A 
x-ray is not sensitive to but may see
large pulmonary arteries
oligemia
Hampton's Hump
Fleishers lines
Melting sign
25
Q

What is Oligemia?

A

lack of blood distal to embolism aka. Westermark’s sign

26
Q

What is Hampton’s Hump?

A

pleural based triangular radiodensity due to infarct, located in the periphery of the lung with its base against the pleura

ICA (6 decks)

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