CVS Flashcards
what is crista terminalis
ms ridge that runs from the SVC > IVC entrance
Wt is Eustaciahn v
IVC valve»_space;» hooked up to the RA
Wt is the main draining v of the heart
Coronay sinus»_space; RA near the TV
multiple cardiac lipoma ass w/?
TS.
PET HOT
arrythimia »_space;> rare VS lipomatous hypertrophy
PDA supplies
inferior wall of the left ventricle
inferior part of the septum.
rhabdomyoma Px
ones with TS regress
no TS»_space; does not regress
Loc: LV
angisarc: RA
MCL of cardiac fibroma
IV spetum
2nd mcc of 1ry CVS tumor in adult
fibroelastoma
MCC of intracardiac mass
thrombus
mcc of mets
lung
melanoma
study of choice for CA aneurysm/ kawasaki
cath angio
Mx of interarterial lipoma
no Mx
Wt is subaortic membrane
it is a membrane prox to the AV. results in obstruction of LVOT. RX> resection. can recur.
ass/ CHD: VSD, PDA amd Coarch
leads to increased afterload, increas MR, decrease EF. no impact on inotrope
what is EF?
EDV-ESV/EDV X100
what is cardiac myocardial mass ?
epicardial myocardial vol - enodcardial myocardial vol/X specific myocardium density.
= 1.05g/ml
what defines DCM?
LV > 5.5 cm
hetrogenous WT and wall thinning
variable LGE
preserved RV vol
AR dynamic
Increased preload > increased SV > increased LV size.
Increased afterload to eject extra blood.
loss of isovolumetric phase
changes in LesMills athelets
RV, LA, LV dil and increased myocardial mass
what is the 1ry determent of AS Sx?
S&S. not the surface area
what is mild AS?
> 1.5 cm2
vel: 2.0-2.9 m/sec
gradient: < 20 mmHg
what is mod AS?
- 1.5 - 1.0 cm2
- 3.0 - 3.9 m/sec
- 20.0 - 39.0 mmHg
what is sever AS
< 1.0 cm2
> 4.0 m/sec
> 40 mmHg
MCC of PS?
cong > 95%. isolated
TOF
RHD ass w/
MS
AS.
Bicuspid AV»_space; AS
what is classic Myxom. MV?
proplase > 2 mm beyond the annular plane.
thickening of the leaflet
non-classic: no thickness
Wt is MV Flail leaflet ?
rupture of the leaflet into > LA. 2/2 to pap. ms or chorida tendinous rupture.
TAVI comp?
LBBB
what is normla MV orifice area
4-6 cm2.
< 1cm»_space;> sever MS
valve prosthesis MR saftey
safe if T< 1.5
DDX of sinotubular junction DDX
1- Marfans EHD syn homoscytinuria OI Loeyes Dietz syn
does MV annulart calc results in valv dysfun or Cl S&S
NOOOOOO
how does carcniod syn affect valves
tethering
thickining
retraction
and DECREASED movement.
what is the size for endovascular access sheeth for TAVI ? in the periphral vessels
minimal 6-8 mm
MCC of ASCENDING Ao aneurysm
ATH.
MS»_space;> sinotubular ectasia. they look differ than aneurysm
rapid progression of aneurysm seen w/
myocotic
what is the most diseased portion of the Ao in dissection
media
when do you treat pulm AVM?
> 3mm
MCC pul. v variant anatomy ?
common LT pul. v trunck
what is 1st line Rx of pt with SVC obstruction
stenting
in pt w/ Marfan’s syndrome wt size of the Ao that meet Sx indication?
> 5 cm
MC tupe of dissection ?
type A.
type B: from BCA !!!
failure of the LT ant cardinal v to involute results in ?
Lt SVC which drains into the LR throug v. of Marshell
GRE seq cons ?
use to create Bright blood seq but it is very Sn to suspeticbity»_space; over estimate regional blood flow
mangement of anomalous CA?
RT > Sx if S&S
LT»_space; SX
other concerning features» slit like, acute angle, anomalous is the dominant one, intramural one
Ebstien anomaly result from ?
1- the septal or the post. leaflet is inadequately separated or inadequately separated from chorda tendina.
how to differ Takayasu and GCA?
both are granulomatous vasculitis and large-mid vessels vasculitis»_space; results in great vessels, CA PA involvement
naroowing not anueyrum
age is the differ
2nd mc 1ry cardiac tum ?
lipoma
painful blue LL edema??
2/2 RF»_space; IVC thrombosis
TAPVR
supracardiac> drains to BCV
cardiac > common v > RA or cornary sinus
infradarciac > IVC or ductus v
how to tell it is LIMA graft?
look for SCA conncection
Rx of renal HTN 2/2 to ATH
medical. not angio or stent
Wt is the arc of Rilion ?
collateral from IMA to occluded SMA
short axis view is ?
perpendicular to the long axis of the heart/ 4 chamber views
prosepective
R wave
more susoptiable to HR variability & motion
what meds used in LBBB and perfusion study
adenosine»_space; antidote: theophylline
ragadonson»_space; gd safety profile
dyprimadole
avoid: exc. dobutamine, arbutamine»_space; +ve iontropic agent
any cardiac valve or annuloplasty are MRI safe/unsafe?
SAFE
Wt is the normal size of the CEA?
up to 1.7 cm in male,
1.5 , female
> that»_space;> ectasia
Normal Av. orifice?
3-4 cm2
MCC of AS in USA»_space; age related degeneration
best seq to eval CVS anatomy?
black blood seq = FSE
bright blood = GRE
SSFP»_space; cine»_space; function. ( higher SNR, CNR, faster acquisition time than standard GRE)
how to orient phase encoding img to measure velocity and flow?
alz perpendicular to the flow
MC site of sinus of valsalva aneurysm?
Rt > noncornary > LT
myocardial LGE thickness ?
< 50% revsculrize
> 50%: medical Rx
optimal way to do myocard perfusion MR?
w/o
2nd option: ragadonson
MV annular calc ass w/?
a marker for increased CA calc
Wondering v?
common pul. v drains all Pul. v»_space; LA
Scimitar syn ass w/?
absence of IVC
horseshoe lung
CHD
A+ supply to lung
Loffler enodcarditis LGE pattern ?
uniform subendo LGE
MC comp of MI?
myocardial remodeling
Most SN study to detect MI?
MR LGE
fibroma loc?
IV spetum and lat LV wall
MS staging
= AS
hibernating vs stunned myocard ?
BOTH no contractility and normal FDG uptake
hiberanting»_space; no perf
stunned»_space; normal perf
DDx of nodular LGE?
amylodosis
sarc
myocarditis.
Excpet: HOCM
microvascular obstruction best seen on ?
1st 25 sec, early
DiGeorge ass w/?
Trucus, VSD, TOF, pul atresia
PAPVR ass w/
sinus venosus
another name for ALCAPSA
White garland syn
presents 1-2 mo
transmural if ?
> 50%
Rx of adeniod cytic ca?
Sx + Rx
M = F
2nd MC trach ca
mucoepidermiod involves bronchi more
PV stenosis MC ass w/
AF ablation
MC of TR
RV dil not IE
myocardial rupture timing post MI?
1st three D
DCIS stage?
0
Hematoma BIRAd
I 2 or 4 !!! If FU indicated
temporal resolution =
rotation speed / 2
= TR X views per set
multiseg recons
when the HR goes up
can be used w/ low pitch only
improves temp res
what is curved planer reform
AKtay fav
see the vessel along its long axis
can result in motion artifact or pseudo lesion
relationship of SAR and T and flip angle
double T, or Flip angle, or TR»_space;» 4X SAR
in SSFP?
Lm = Tm
what is parallel imaging?
using multiple PEG steps to reduce scan time
might result in K space missing info»_space; interpolation
in RS study ?
modified mAs is used»_space; low dose in sys but enough to calc fun
high dose in diastole»_space; to eval CA
MX of LAD w/ myocardial bridging?
BB to decrease after load
indication for graft bypass?
RCA stenosis > 70%
LCA > 50%
ATH plaque w/ high RF for rupture?
\+ve remodeling low HU ulceration spotty calc fatty
Mx of CA stent?
drug eluting stent > AC for a yr
bare metal stent > AC X 1 mo
adenosine dose for perfusion?
140ug/kg/min
ARVD criteria
1- RV wall motion ab
2- RV EF < 40%
3- RV EDV > 110ml/m2
no fatty infil
Mx of con pericardial?
Sx
but con mayo»_space;> medical
MX of noncompaction LV?
HTx.
arrhythmia meds, AC, ICD
MCC of death»arrthemia
T2* in hemochromatosis
< 20msec
if sever < 10 msec
Takabousu CM?
acute reversible HF basal hyperkinesia apical akinesia negative cath could be life threatening 2/2 HF, arrhythmia,shock Mx: symptomatic
Mx of HOCM?
low risk pt: BB, CCB»_space; reduce risk of death
high risk pt: FHX of sudden death, LGE»_space; ICD
ACEI, nifidpine, nitrates»_space; CI»_space; decrease afterload
LGE means»_space; ab cell web»_space; necrosis»_space; arrhythmia»_space; sudden death
Constrictive myocarditis def?
normal LV size. normal sys fun
low LV, RV compliance\
biatrial enlargement
prominent early diastolic filling but small late one
MC of 2ry infiltrative DCM?
amyoldosis
involves all the heart
CI for HTx
MCC of HTx in adult and kids?
DCM
MCC of DCM in infant?
idio
inborn error of met
MCC of DCM in kids?
NM dys
myocarditis
earliest S&S of Chagas diz?
conduction ab
Mx of rhabdomyoma?
FU, will regress
but fibroma»_space; HTx why»_space; you can’t respect that big mass
SGV aneurysm loc?
RCA
pay attention to sternotomy changes
no uptake in PET
comp of IE AV?
conduction ab chordal rupture aneurysm of the valve abscess no AS
sever MS might result in ?
PV waveforms blunting
MCL of rhabdomyoma
LV
RHD app
thickening, calc, and fissures fusion of the MV and AV might involve chordae and pap ms
indicator of MS severity
MV surface area # AS severity
it leads to P.HTN»_space; decrease flow across PA
how manage valves and MR?
they are safe < 1.5 T
wait 6-8 for newly weakly magnetic placed valves
why pericardial thickness is overestimated in MR?
chemical shift artifact
motion
limited SR
CI of ASD closure device?
small secundum, no HD sig
primum
no enough roof > sinus venous or unroofed etc.
HD sig = Qp/Qs> 2
MCC of ASD device comp?
device embolization or malpositioning
arrthymeia
erosion
AF
SVT
Ms of unroofed CS?
none unless HD sig
connection between RA and LA
Mx of VSD?
membranous won’t go spontaneous closure
ms VSD > spontaneous
BOTH»_space; needs IE prophylactic ABx
Mx of similar?
if HD sig»_space; Sx
left > right shunt
but other single PAPVR > no Rx
what is Senning/ Mustard ?
Both are atrial switch
Mustard ass w/ resection of the atrial septum
SVC and IVC»_space; LA, LV»_space; PA
PV»_space; RA, RV > Ao
botha are inferior to Arterial switch 2/2 arythemia
TA ass w/?
tricuspid or quadricuspid valve.
quadricuspid AV ass w/
AR
what is ROSS procedure?
PV > AV
prosthetic > PV
Ebstein valve morphology?
ant leaflet sail sign
apically orineted
ass/w ASD secundum
ass w/ BNZ
Mx of anomalous RCA or LCA w/ malignant course?
if pt is old do stress test only
if young»_space; Sx
comp of baffle procedures : sending/ mustard?
baffle leak, obstruction
arrythemia
RV dysfunction»_space; RV is not meant to bear sys pressure
TR
MCL of sinus of Vals?
Rt and noncornary cusp.»_space; rupture»_space; RV > RA
1st line Mx of SVC obstruction?
stenting
BLOOD SUPLLY OF THE PAP ms
anteriolat > LAD and LCx. two vessels > less risk of rupture
postmedial»_space; RCA»_space; more risk of rupture 2/2 MI
TI in STIR?
330 msec
TAPVR ass w/
TV atresia
Asplenia
MCC ass defect w coarcatation
Bicuspid
Leaflet
B/l thrombus
TI needs to be long to detect thrombus
TI for amylodosis
350 msec
Normally 200 Msec