Cardiac

Question 1

Left atrial enlargement on CXR

Answer 1

1. Double density right heart border
2. Widening of the carinal angle >90°
3. Elevation of left main bronchus

Question 2

5 Ts of cyanotic congenital heart disease

Answer 2

1. Tetralogy of Fallot
2. Transposition of the great arteries
3. Truncus arteriosus
4. TAPVR
5. Tricuspid valve abnormalities & hypoplastic right heart syndrome

Question 3

Egg on a string

Answer 3

Transposition of the great arteries

Question 4

Snowman

Answer 4

TAPVR

(or figure of 8 sign)

Question 5

Figure 3 sign

Answer 5

Coarctation

Question 6

Box shaped heart

Answer 6

Ebstein’s anomaly

Question 7

Boot shaped heart

Answer 7

Tetralogy of Fallot

Question 8

Scimitar sword

Answer 8

PAPVR

(with hypoplasia)

Question 9

Cyanotic congenital heart disease:

Right sided arch

Answer 9

ToF (most common)
Truncus (most associated)

Question 10

Non-cyanotic congenital heart diseases

Answer 10

ASD
VSD
PDA
PAPVR
Coarctation (post-ductal)

Question 11

Most common congenital heart disease

Answer 11

VSD

Membranous most common (70%). ~70% close spontaneously.

Question 12

PDA

3 things

Answer 12

1. Prematurity
2. Maternal rubella
3. Cyanotic heart disease

*closes at 24hrs after birth (functionally)

Question 13

Most common ASD

Answer 13

Ostium secundum (50-70%)

May close without treatment.

Question 14

Ostium primum ASD

Answer 14

Down’s syndrome
DiGeorge syndrome

*larger and lead to right heart dilatation

Question 15

Sinus venosus ASD

Answer 15

PAPVR

Question 16

ASD and hand/thumb defects

Answer 16

Holt Oram

Question 17

Right sided PAPVR

Answer 17

Sinus venosus ASD

Question 18

Right sided PAPVR + pulmonary hypoplasia

Answer 18

Scimitar syndrome

Question 19

PAPVR vs TAPVR

Answer 19

PAPVR
1 or more of 4 pulmonary veins drain into RA

TAPVR
ALL pulmonary veins drain into the right side of the heart.
Large PFO or ASD required for survival.

Question 20

Most common cause of cyanosis during first 24hrs

Answer 20

Transposition of great arteries

Aorta and pulmonary trunk switch.

Depend on ASD, VSD (most common) or PDA for survival. PDA closure at 24hrs causes cyanosis.

Question 21

Tetralogy of Fallot consists of…

Answer 21

1. VSD
2. RVOT obstruction
3. Right ventricular hypertrophy
4. Overriding aorta

*pentalogy of Fallot also has added ASD

Question 22

Most common malignant cardiac primary tumour

Answer 22

Angiosarcoma

• Likes the RA
• Pericardium often involved
• Sun-ray appearance
• Cause right heart failure/tamponade

Question 23

Most common cardiac tumour to involve the valves

Answer 23

Fibroelastoma

*systemic emboli common

Question 24

Most common fetal cardiac tumour

Answer 24

Rhabdomyoma

• Prefer LV
• Essentially a hamartoma
• Tuberous sclerosis
• Likely to regress without treatment

Question 25

Cardiac fibroma

Answer 25

• Low T1/T2. Enhance with Gad. • Likes the IV septum • 2nd most common in kids

Question 26

Most common primary cardiac tumour in adults

Answer 26

**Left atrial myxoma (50%)** • **MEN syndrome**, **Carney complex** • Attached to **interatrial septum** by stalk • May **prolapse** through valve • Heterogeneous • Enhances • Can calcify

Question 27

Cardiac tumour vs thrombus

Answer 27

Tumour will **enhance**

Question 28

Ebstein anomaly and Nirvana. What is the link?

Answer 28

1. Box-shaped heart 2. Lithium (maternal lithium exposure)

Question 29

When does PDA close?

Answer 29

Functionally at 24-48hrs Anatomically ~1 month

Question 30

What medications can be used to maintain PDA patency?

Answer 30

**Prostaglandin E-1** *Indomethacin used to **CLOSE** PDA

Question 31

Congenitally corrected TGA

Answer 31

L type **”L type is Lucky”** and does not require surgery

Question 32

Risk factor for TGA

Answer 32

Maternal diabetes

Question 33

Aortic arch anomaly with posterior indentation of oesophagus

Answer 33

**Aberrant right sublacvian artery** **Right** at the back **Raiders triangle** (obliteration of retrotracheal

Question 34

Aberrant left pulmonary artery

Answer 34

Between trachea and oesophagus “**Ploughs** through the middle”

Question 35

Hyparterial vs eparterial bronchus

Answer 35

The hypest parties are left wing and everyone gets down Everyone Remembers ABBA + Eparterial Right Artery Below, Bronchus Above