Masses/Thrombus/Endocarditis Flashcards
What are the 3 RA structures that can mimic masses?
- Crista terminalis
- Eustachian valve
- Chiari network
Are benign or malignant primary tumours more common?
Benign
Benign tumour that is attached by a stalk to the IAS
Myxoma
LA/IAS, mobile, plop sound, large
Myxoma
Most common primary benign tumour found in adults
Myxoma
Benign primary tumour that is small and often attached to valves
Papillary fibroelastoma
Primary benign tumour made of fatty tissue
Lipoma
Most common valvular heart tumour
Papillary fibroelastoma (PFE)
Where are PFE’s usually found on the AV and MV/TV?
AV: aortic side, MV/TV: atrial side
Echogenic, encapsulated tumour
Lipoma
Lipoma vs. Lipomatous hypertrophy of the IAS
Lipomatous hypertrophy has a dumbbell appearance where it is not found over the foramen ovale
Most common primary malignant tumour
Angiosarcoma
Primary malignancy that is made of striated muscle and usually found in younger patients
Rhabdomyosarcoma
Which is more common, primaries or mets?
Mets are way more common
Thickened/retracted TV leaflets and massive TR can be a sign of what?
Carcinoid heart disease
What is Virchow’s triad for thrombus?
- Endothelial injury (abnormal walls)
- Abnormal flow (hemodynamic changes: stasis)
- Hypercoagulability
What is smoke?
A precursor to thrombus
Is older thrombus more or less echogenic?
More echogenic
Is protruding more acute or chronic? Is protruding or mural more at risk for embolus?
Acute and protruding more likely to embolise
Why is TEE the #1 choice for assessing LA thrombi?
The LAA is seen and the LA is closest to the probe
Name 3 predispositing factors for thrombus
Stagnant flow, aneurysms, shunts, a-fib, rheumatic disease, congenital HD, prosthetic valves
A microbial infection that enters the heart and may cause tissue destruction or abscess formation
Endocarditis
Most common cause of acute endocarditis
Staph infection
CHF, flu-like symptoms, chest pain, fever, +blood cultures
S/S of infective endocarditis
What is the clinical triad for IE?
- blood cultures
- Fever
- New murmur
What are the features of a vegetation?
Upstream a valve, mobile, irregular
T/F a bi/unicuspid AV is most likely to get involved with endocarditis
True
What is the most common veg location? Which side is it usually on?
MV on atrial side
Which side is an AV vegetation usually found?
LV side
