Cardiac Radiology

Question 1

Where are the aortic and pulmonary valves located PA film?

Answer 1

Superiorly

AORTIC: MIDLINE
- Axis points towards right shoulder

Pulmonary valve: Left of aortic valve
- Above right ventricle

Question 2

Where are the AV and PV valves located on a lateral film?

Answer 2

Pulmonary:

• Just above right ventricle ANTERIOR to AV
• Axis directed superoposterior

Question 3

Where is the MV valve PA film?

Answer 3

Superimposed on left ventricle
Larger than aortic or pulm valves
Inferior to AV/PV
Posterior to AV
Axis points towards APEX

Question 4

Where is the TV in lateral PA/Lateral Film?

Answer 4

PA film: Overlies spine
- Axis is verticle and splits right atrium and right ventcile

Lateral:
Viewed End on

Question 5

What is the ratio that the heart may be enlarged?

Answer 5

Should be less than 50% of transthoracic width

Question 6

What is characteristic of LVE?

Answer 6

DOWN and OUT

Lateral view: will be 2 cm behind IVC

Question 7

What is characteristic of LAE?

Answer 7

Normal concave left border becomes straight

3rd mogul

Double density shadow

Elevate left mainstem bronchus

Question 8

What is characteristic of RVE?

Answer 8

Boot shaped heart in marked enlargement (coeren sabot)

Example is TOF

Lateral view: Fills in retrosternal space

Question 9

What is characteristic of RAE?

Answer 9

Prominent right heart border

Cannot use lateral film

Question 10

What are some radiographic evidence for CHF?

Answer 10

1) REDISTRIBUTION of PULMONARY BF to UPPER LOBES (WP: 15 mmHg)

2) Vessels become fuzzy and indistinct (interstitial edema) capillary wedge pressure (18-22 mmHg)
- Can also see peribronchial cuffing
- Kerley lines present

3) Pulmonary edema present (capillary wedge pressure 25 mmHg)
- Bilateral symmertric airspace disease in both lungs