RADIOGRAPHY CARDIOLOGY Flashcards
How can you tell a RVE from LVE
RV will obscure the retrostermal space on a lateral view
LV will obscure downward towards the diaphragm (spine space is opaque now)
Comon causes of LVE
Aortic stenosis, HTN , CHF
Common causes of RVE
pulmonary stenosis, tetralogy of Farllot
RVE vs LVE in comparison to the lower part of the retrosternal space on Lateral view
RVE will fill the lower retrosternal space
LVE will spare the lower retrosternal space and project downward toward the diaphragm
In what infant heart abnormality do you see a concave waist line almost like a boot?
Tetrology of farllot
RVE vs LVE in comparison to the spine and diaphragm
LVE will take over the black part of the spine and blend with the diaphragm
RVE will not touch the spine and remain away from this area
patient presents with mitral insuficiency and CXR shows double shadow on the right side of heart . Which chamber is enlarged?
LAE
first clue for LAE
straightening of the cardiac waistline
followed by the double-shadowing
What is a classic sign seen in Tetrology of Fallot on a CXR PA view?
RVE - seen as the boot shape
What 3 characteristics are seen in Rheumatic fever ?
-straight line on the waist line of heart
-double shadow
-splaying of the carina (bigger angle)
When does pericardial effusion occur
how many mL is to much ?
when >250 mL spill into the pericardium
what shape would a Pericardial effusion show? and how to confirm
shapeless heart projecting equally on both sides like a water balloon , needs ECHO
Rapid deceleration motor vehicle accidents are a common cause of?
aortic trauma (will look wide at the arch and also know everything will move forward)
LAE as seen on PA and lateral view
PA–> stright line on wasit, double shadown
Lateral–> displacemen of esophagus
what are the 5 components of Pulmonary interstitial Edema seen in CHF?
hint ME.KFC
Markings (acentúate)
Effusions
Keyley B lines
Fissures (think b/cfluid here)
Cuffing (recall this is also seen with interstitial pneumonias -vital pneumonias)
what componets are seen with Pulmonary alverolar edema as seen in CHF
Bat-wing densities in the center (outer 1/3 spared)
Cephalization– upper vessels will look more prominent
what is an abnormal find with CHF that can raise a concern for weird mass?
pseudotumor (fluid gets trapped makes it look like a tumor
another name for fluid in inter-lobular septa
Kerley B lines (horizontal lines seen)
what is the greatest concern with Aneurism
dissection (can tear apart)
How to rule out an aneurysm which also over interpreted?
widening of the mediastinum
Clinical presentation of an aortic Aneurysm or dissection
abrupt tearing chest pain, hypotension, unequal peripheral pulses
Where do most aortic dissections begin and can have be treated surgically urgently
Ascending Aorta
Gold standard for Aortic Aneurysms
Contrast-enhanced CT showing long or globular shape
types of Aortic dissections?
Type A– at ascending aorta seen on right side of the heart – need Sx asap since it can result in MI
Type B – descending aorta–can wait until it gets bad
How does a case of Aortic dissection present? On CXR
-Tearing pain
-CXR: wide mediastinum, left pleural effusion, LVE if patient is HTN
What patient is at most risk for Aortic dissection ?
Long hx of HTN
Conditions that predispose Dissections?
ATHEROSCLEROSIS, Marfan syndrone, Ehler danlos, Syphyllis crack coccaine , trauma
Aortoc aneurysm clinical finds on HTN patient
sudden searing chest pain radiation to the back , abdomen or neck
most common cause of trauma to the aorta
Deceleration injuries
What would you see on an Aortic Trauma CXR and on CT
CXR-Wide mediastinum
CT-A- demonstrates intimal flap, contour abnormalities, hematomas
Most pts die before they reach the hospital unless it is an incomplete tear.
