Imagine of the heart

Question 1

Advantages of chest x-ray

Answer 1

Quick, easy, cheap, lung and cardiac information

Question 2

Disadvantages of chest x-ray

Answer 2

Limited anatomy, no functional information

Question 3

Cardiac failure

Answer 3

• Ischaemia/infarction
• Heart rate/rhythm disturbances
• Valve disease
• Herat muscle disease
• Left ventricular failure leads to pulmonary oedema
• Right ventricular failure leads to peripheral oedema and raised JVP
• Right ventricular failure is consequence of left ventricular failure - congestive cardiac failure

Question 4

What is an echocardiagram?

Answer 4

• Uses U/S to provide images of cardiac anatomy
• Information on cardiac function - suspected cardiac failure
• 40-45 mins for scan
• Diagnosis, prognosis and follow up

Question 5

Advantages of echocardiagram

Answer 5

wide range of information, good anatomy, cheap, accessible, non-invasive

Question 6

Disadvantages of echocardiagram

Answer 6

operator dependent, body habitus, limited to structure and function of heart

Question 7

Pulmonary hypertension

Answer 7

• RV muscle wall thickens - pressure increases

- RA struggles to pump blood

Question 8

Coronary arteries

Answer 8

• Can’t see with ultrasound
• Affected in Mis
• Identify abnormal disease by imaging - before becomes extensive
• L and R coronary arteries arise from aortic root
• Visualised by formal and CT coronary angiography

Question 9

Formal angiography

Answer 9

• Gold standard for detecting atherosclerotic disease
• Determines presence of stenosis
• Defines therapies like stents
• Determines prognosis
• Complications: vascular complication of puncture site, contrast reaction, cardiac arrythmias, coronary artery dissection

Question 10

Coronary angiography

Answer 10

• Puncture femoral artery and pass catheter through iliac arteries into coronary arteries
• Contrast injected and vessels imaged
• Non-invasive way of assessing anatomy, disease, cardiac function and patency of stents
• However not therapeutic, less specific than formal angiography
• CT scan of heart during diastole after IV contrast injection
• Images reformated in multiple planes
• Good negative predictive value
• Few complications - radiation, contrast reaction

Question 11

Coronary artery stenosis

Answer 11

• Narrowing of coronary arteries due to build up of fatty plaque
• Reduces blood supply to mediastinum
• Angina or heart attack if severe
• Treated with medical management, angioplasty, stents, bypass

Question 12

Cardiac MRI

Answer 12

• Non-invasive with no ionising radiation
• Good for evaluating anatomy and function of the heart
• Evaluates effects of coronary artery disease
• Excellent soft tissue definition - tumours, infections, inflammatory conditions
• However can’t evaluate coronary arteries and MR compatibility