Miscellaneous

Question 1

Amount of fluid needed for tamponade in acute scenario

Answer 1

250 cc

Question 2

Imaging findings of congenital absence of pericardium

Answer 2

Lung interposed between the aorta and pulm art
Can cause levorotation of the heart (elevated apex on the radiograph)
Associated with congential abN - ASD, PDA, etc.

Question 3

Imaging features of constrictive pericarditis

Answer 3

Reduced diastolic filling, cone like ventricles, increased interventricular dependence, septal bounce, dilated atria, pericardial thickening and calcification

NB: not all cases of pericardial calc are associated with constriction

Question 4

Most common primary to met to the pericardium

Answer 4

Lung cancer***

Melanoma likes to go to the myocardium

Question 5

Most common primary benign cardiac tumours in a) adults (top 3) and b) children

Answer 5

Myxoma>lipoma>fibroma (adult) - fibromas seen in Gorlin syndrome…
Rhabdomyoma (child) - associated with TS

Question 6

Most common malignant primary cardiac tumour in a) adults and b) children

Answer 6

a) Angiosarcoma But METS are still the most common malignancy overall!! (20-40 X more common)
b) Rhabdomyosarcoma

Question 7

Most common location of myxoma

Answer 7

left atrium, attached to fossa ovalis of interatrial septum

Question 8

Features of Carney complex

Answer 8

Rare AD MEN syndrome
Cardiac mxyomas (2/3 of pts), skin pigmentation (blue nevi), extra-cardiac myxomas including skin and mammary

Do not confuse with Carney triad (CARNEY COMPLEX IS CARDIAC)

Question 9

Imaging differentiating features between thrombus and myxoma

Answer 9

Myxomas usu arise anteriorly from interatrial septum

Thrombus located posterior, do not enhance

Question 10

Most common primary tumour of cardiac valves

Answer 10

Papillary fibroelastoma (more commonly on left sided valves), occasional endocardial

Pedunculated, small, mobile, best seen on ECHO, can cause distal emboli

Question 11

Most common benign cardiac tumors in children

Answer 11

Rhabdomyomas
Usu < 1 yo, spontaneously regress ante-natally or in early infancy
Approx. 60-80% of patients with TS have these, and 50% of those with rhabdomyoma will have TS

May have hydrops, arrhythmias, murmurs, CHF
Intramural or intracavitary mass in ventricle; usually left sided

Second most common is fibroma (also <1 and ass. with TS and Gorlin), causes arrhythmia and sudden death - intramural mass too but will be low on T2; require surgical resection

Question 12

Most common arteries involved in coronary artery fistulas

Answer 12

RCA, left main
Drainage: mainly right side (RV>RA>PA)
*left to right shunt causing coronary artery steal

Question 13

Subtypes of pulmonary HTN

Answer 13

1 - idiopathic/familial (CVD)
2 - left heart disease
3 - lung disease or hypoxemia
4 - chronic thrombotic or embolic disease
5 - miscellaneous

Question 14

Most common cause of sudden death in young people

Answer 14

1) HOCM
2) Anomalous coronaries
3) Dilated CM

Question 15

Causes of pseudoaneursym in root or sinuses

Answer 15

Trauma, endocarditis, syphilis, congenital (SOV)

NB: congenital normally involve the right coronary sinus, while infective can involve any valve

Question 16

Most common location for traumatic aortic injury

Answer 16

Isthmus (just distal to origin of left subclavian)

Question 17

Most common location for disruption of aortic arch

Answer 17

b/w origins of left common carotid and subclavian arteries (extreme form of coarctation)

*IAA commonly associated with DiGeorge