Congenital heart disease Flashcards
What is the MC congenital heart disease presenting in adult patients?
Atrial septal defect which is an opening between atria
What is the tetralogy of fallot?
obstructed pulmonary outflow
ventricular septal defect
Rt ventricular hypertrophy
aorta over riding interventricular septum
What are the S/S of congestive heart failure?
Kerley's lines Enlarged heart Enlarged superior vena cava Pleural effusion Pulmonary edema Cephalization of blood flow
what are Kerley’s lines?
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
What are the signs of pulmonary edema asso w/ CHF?
“Batwing”
“Butterfly”
“perihilar haze”
What is the mechanism of failure of LEFT sided heart failure?
congests pulmonary tissues
What is the mechanism of failure of RIGHT sided heart failure?
congests body tissues
What are the S/S of CHF?
Enlarged neck veins, pitting edema, shortness of breath, chronic non-productive cough, nocturia, enlarged liver
What is cephalization?
vessels in the upper chest at more prominent as a manifestation of pulmonary venous hypertension
What causes hilar haziness?
enlarged pulmonary veins with perivascular fluid collection leads to full, hazy hilum
Describe Kerley B lines
Early phase of CHF
2-3 cm long in bases perpendicular to pleural surface
due to increased lymphatic flow & fluid in interstitium
What happens during late phase CHF?
basal congestion, pulmonary edema which shows bilateral diffuse alveolar findings with butterfly distribution, air bronchograms, & soft coalescing densities
What is pleural effusion?
Free (gravity dependent) or loculated (secondary to fibrosis) collections of transudate, exudate, blood or chyle in pleural space
Where in a normal lung is the horizontal fissure located?
in the middle of the lung; if raised, indicates atelectasis
What is pulmonary edema?
fluid accumulation in the extravascular space; due to increased venous/ capillary pressure
What are causes of pulmonary edema?
MC left sided heart failure
capillary permeability
renal failure
obstructed lymph channels
What are the radiographic signs of pulmonary edema?
radiodense septal lines (Kerleys ABC)
hilar haze
peribronchiovascular haze
subpleural edema
What are the 3 types of Kerley’s lines?
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
How does “butterfly”, “sunburst”, “batwing” sign appear on radiograph?
radiodense lines radiating from hilum
How does air bronchiogram appear on radiograph?
radiolucent shadows thru consolidation
What creates a pulmonary thromboembolism?
a clot forms from the sticky nature of blood in lower extremity due to decreased pressure
Where do thromboemboli arise from?
venous circulation, bone marrow, amniotic fluid, etc
Most from deep veins of lower extremity
What is the difference between a thrombo and an embolism?
thrombo = stationary clot embolism = moving clot
What are some radiographic findings of pulmonary thromboembolism?
x-ray is not sensitive to but may see large pulmonary arteries oligemia Hampton's Hump Fleishers lines Melting sign
What is Oligemia?
lack of blood distal to embolism aka. Westermark’s sign
What is Hampton’s Hump?
pleural based triangular radiodensity due to infarct, located in the periphery of the lung with its base against the pleura
