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Flashcards in Cardiac Deck (33)
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1

Massive enlargement of the main pulmonary artery
2

Idiopathic pulm rterial hypertension

Eisenmengers

2

Coarctation of Aorta
Associated conditions
4

Bicuspid AV - 85%
Turners
AR
PDA

3

Coronary artery aneurysms
Causes 3
Criteria
Anticoagulation

Atherosclerosis
Trauma/iatro
Vasculitis ( Kawasaki)

1.5x normal diameter

if >8mm anticoag

4

Heart disease with
Normal heart size
+ LAA
no signposts

MS

Restricted compliance : Restrictive CM, hypertrophic CM, constrictive pericarditis

5

Normal heart size with aortic enlargement
or no signposts

AS

Acute MI
Restrictive CM
Hypertrophic CM
Constrictive pericarditis

6

d-TGA features

RF
Post surgical

LV to PA
RV to Ao

Cardiomegaly
Plethora
Cyanosis
Narrow mediastinum

Arterial switch --> Pulm stenosis
Atrial switch - RV dys, baffle stenosis, clot

7

Cyanosis
Cardiomegaly
Pulm plethora
Type 4 lesions
T

narrow superior mediastinum:
TGA
Truncus
TAPVR
(T) ingle ventricle

8

Vascular rings
Causes 2

Right arch with aberrant L SCA
Double aortic arch

9

Occult cardiac shunts
3

Sinus Venosus ASD (SVC or IVC connects to LA)
PAPVC
Supracristal VSD (subpulmonic)

10

Cardiomegaly with LAE

MR

11

Cardiomegaly with Aortic enlargement or
No signposts

AR

Idiopathic DCM
Ischaemic CM
TR
RVF
Pericardial effusion

12

In intracardiac shunts what is Qp/Qs?

Ratio of pulmonary flow to systemic flow

Ratio > 1.5 requires surgical correction or evidence of RV overload

13

Non cyanotic heart disease with pulmonary plethora :
LAE
no LAE
Group 1

LAE:
VSD
PDA

No LAE
ASD
PAPVR

14

Non cyanotic heart disease with pulmonary plethora :
AoA Enlargement
No AoA E

AAE:
PDA

No AAE
VSD

15

Order of RCA branching
1
2 - %
3

1. Conus branch ( to infundibulum)
2. SAN artery (60%)
3. Acute Marginal branches
4. (PDA)

16

Morphologically right ventricle
two features

Moderator band
Contraction of outflow tract(contains muscle)

17

CT features of high risk coronary plaque
4

Calcific densities- punctate
Positive remodelling(expansion of vessel)
Napkin ring sign
Hypodensities within plaque

18

Sinus of Valsalva Aneurysm
demo
CMR criteria

Rare (0.15-3.5%)
Right sinus 72 %
Localised weakness of elastic lamina(cong/acq)
CMR criteria : origin above aortic annulus, saccular shape, normal root/AA dimensions
Inform ASAP

19

Lipomatous hypertrophy of RA
demo
CMR features

rel common 1-8%
pseudomass, age/BMI
most asymptomatic/SVT
CMR: freq septal location with thickening > 2cm, spares fossa ovalis, rarely involved RA free wall
FS TSE diagnostic

20

Anatomic cardiac pseudomasses
3

Prominent crista terminalis
Prominent chiari network/ eustacian valve
Moderator band

21

DDx for LV non compaction

DCM
ARVC
Athlete- hypertrabeculations

Trabecular mass > 20% or
Non com/compacted ratio > 2.3

22

Myocardial fatty infiltration vs ARVC features

ARVC :
young-middle aged, male
location : RVOT, RV free wall, RV septum, LV free wall
Subepicardium
Thin myocardium
Enlarged RV

23

Features of true perfusion defect on CMR
4

Non Gd enhancing dark zone
Persists through atleast 3 beats
Spreads from subendocardium to subepicardium
More conspicous during stress

24

AMI vs acute myocarditis

AMI : subendocardial LGE + oedema
myocarditis : subepicardial

25

LCA origin from Right sinus
possible pathways
4
ARCA>ALCA

Interarterial ( malignant)
retroarotic - commenest
Prepulmonic
Septal/subpulmonic

26

Anomalous origin of LCA from PA
ALCAPA

Bland white garland Xd
Obligatory ischaemia
0.25-0.5% of CHD
Infantile - direct reimplan
Adult - ligation/CABG

27

Coronary artery fistula
drainage

usually drains to low pressure chamber
RV 41%
RA 26%
PA 17%
CS 7%

28

Functionally significant/ potentially malignant coronary artery anomalies
4
Origin
Course
Termination

Origin from opposite sinus with interarterial course

ALCAPA

CA fistula

Coronary atresia/hypoplasia

29

Signs of constrictive pericarditis
3

calcified, thickened pericardium
mass effect on vessels/chambers
early diastolic flattening of IVS - MRI

30

Congenital absence of pericardium

complete/partial
Levorotation of heart
absence of pericardial recess ( PA-AA) - lung dips into it