Plain Film Imaging of Heart Disease Flashcards
Ddx for enlarged heart
cardiomyopathy due to CHF, valvular regurgitation, high output/overload states, pericardial effusion, paracardiac mass
key structures to evaluate for in cardiomegaly
left atrium, aorta
enlarged left atrium + cardiomegaly
mitral regurgitation
enlarged aorta + cardiomegaly
aortic regurgitation
normal size heart with cardiovascular disease DDX
valvular stenosis (aortic/mitral), PAH, hypertrophic cardiomyopathy, restrictive physiology, acute MI
key structures to evaluate with cardiac disease and normal size heart
left atrium, aorta
normal size heart, enlarged left atrium
mitral stenosis
aorta enlarged + normal size heart
aortic stenosis or aortic aneurysm
right ventricular enlargement
displaces cardiac apex leftward; opacification of retrosternal clear space
right atrial enlargement
lateral bulging or elongation of right heart border
left ventricular enlargement
left heart border enlarged; displacement of apex in inferior/left direction
does not cause enlargement of external contour of ventricule in HOCM
left atrial enlargement causes
mitral regurgitation (cardiomegaly) or with mitral stenosis (normal heart size)
LEFT ventricular aneurysm
focal outpouching of wall with all layers of muscle affected; associated with occlusion of LAD
anterolateral/apical wall of LV, may calcify
abnormal contour of midportion of left cardiac border
False aneurysm/pseudoaneurysm
contained ventricular ruption with pericardial adhesions preventing rupture; no myocardium
occlusion of circumflex or R coronary arteries
seen in upper diaphgragmatic/posterior wall; may increase in size and rupture
treat surgically
Dressler syndrome
autoimmune pericarditis; associated with pericardial/pleural effusions
causes of endocarditis
IV drug use, poor dental hygiene, diabetes, prosthetic valves
diagnosis of endocarditis
echocardiography; CT if >1 cm in diameter; look for perivalvular abscess or extracardiac complications like septic PE
how to evaluate prosthetic valves
on lateral view: sternal/diaphgragmatic junction and carina
tricuspid is right/anterior to mitral valve
pulmonic valve is superior/leftward
mitral regurgitation
secondary to MI, acute pulmonary edema with normal size heart
can cause left atrial enlargement
enlargement of left atrial appendage
seen with rheumatic disease; chronic mitral regurgitation
mitral stenosis
normal heart size, left atrial enlargement; elevated pulmonary venous pressure
mitral annular calcification
calcium deposited along fibrous annulus encircling mitral valve
increased risk of stroke, Afib, cardiovascular events
aortic stenosis
LV hypertrophy, normal heart size; ascending aorta enlarged
aortic regurgitation
LV enlargement + cardiomegaly
pulmonary vasculature normal
right sided valvular disease
carcinoid disease; tricuspid/pulmonic valve dysfunction
