Cardiac Congenital Abnormalities

Question 1

egg on a string sign

Answer 1

transposition of the great arteries

Question 2

snowman sign

Answer 2

total anomalous pulmonary venous return

Question 3

scimitar sign

Answer 3

partial anomalous pulmonary venous return

Question 4

gooseneck sign

Answer 4

endocardial cushion defect

Question 5

figure of three/reverse figure of three

Answer 5

aortic coarctation

Question 6

boot shaped heart

Answer 6

TOF

Question 7

box shaped heart

Answer 7

ebstein anomaly

Question 8

what is the most common cyanotic congenital heart lesion found in neonates?

Answer 8

transposition of the great arteries

Question 9

transposition of the great arteries is common in infants born to what kind of mothers?

Answer 9

diabetic mothers

Question 10

how many types of TAPVR are there?

Answer 10

4

Question 11

which type of TAPVR is the most common? And what does this mean as far as the anomalous pulmonary veins?

Answer 11

type I; they terminate at the supracardiac level

Question 12

in terms of radiographic signs, the structure in which the anomalous veins terminate appears how on XR?

Answer 12

dilated

Question 13

what is the size of the RH in TAPVR? why is this the case?

Answer 13

the right heart is prominent b/c of the increased flow volume, BUT the LA remains normal in size

Question 14

the scimitar sign is produced by an anomalous pulmonary vein that drains?

Answer 14

any or all of the lobes of the Right lung - IOW, right atrium is the point of return for the blood from some (but not all) of the pulmonary veins.

Question 15

this deformity in endocardial cushing defect is caused by a deficiency of both the conus and sinus portions of the inter-ventricular septum, with narrowing of the LV outflow tract

Answer 15

gooseneck-shaped deformity

Question 16

overall the most common radiologic finding in this condition is an upturned cardiac apex

Answer 16

ToF

Question 17

cystic medial necrosis is a common occurrence at the level of the coarctation - this condition predisposes the aorta to what?

Answer 17

an infective endartertitis, intimal dissection and aneurysm.

Question 18

coarctation of the aorta occurs with increased frequency among patients with what syndrome?

Answer 18

Turner Syndrome

Question 19

what are the two main types of aortic coarctation?

Answer 19

localized and tubular hypoplasia

Question 20

what is the most common type of aortic coarctation?

Answer 20

localized (aka post-ductal or adult type) - it is characterized by a focal narrowing of the aorta almost always at a site just beyond the origin of the left subclavian artery or the ligamentum arteriosum

Question 21

rib notching which usually occurs at the third or fourth ribs through the eighth is commonly seen in which congenital heart disease?

Answer 21

coarctation of the aorta

Question 22

T or F: the first and second ribs demonstrate notching

Answer 22

FALSE

Question 23

this is characterized by the downward displacement of the septal leaflets of the tricuspid valve into the inflow portion of the RV

Answer 23

ebstein anomaly

Question 24

T or F: in ebstein anomaly pts the RA becomes enlarged and a R to L shunt (through a patent foramen ovale or ASD) is seen.

Answer 24

TRUE

Question 25

what is the most consistent imaging feature of ebstein anomaly?

Answer 25

RAE - also be sure to look for LA to be normal, the left cardiac contour to be shelved (b/c of dilated RV outflow) with a small aorta and an absent pulmonary trunk