R Flashcards
(15 cards)
True and false ventricular aneurysms of ventricle
1. Size of mouth and body
2. Location
True aneurysm - mouth is wider than body , myocardium is intact, usually involves anterolateral wall
False- mouth is narrow compared to the body, myocardium is not intact(pericardial adhesions contain the rupture)
Usually posterolateral wall, high risk of rupture
Biventricular thrombus
Endocardial fibrosis
Raised serum eosinophilia
Loeffler/ eosinophilic is endocarditis
Maculopapular rash
Lymphadenopathy
Erythema of palms
ECG shows cardiology with coronary artery aneurysm
Kawasaki
TOF associations
Think of Tof what u see
Multiple vsds
(Overriding of aorta) so pda
M/c- right sided aortic arch
Extracardiac anomalies: downs digeorges alagille
Pericardial agenesis/ pericardial defect
Radiologically, it presents with the following :
levoposition of the heart
prominent pulmonary artery
air interface in the aorto-pulmonary window or between the base of the heart and the diapgragm
Ass with asd, pda,Mitral stenosis, TOF
Short 4th metacarpal
Bilateral inferior rib notching
Turners
Rib notching due to coarctation
Others: madelung
Lymphedema of hand
A 37-year-old woman involved in a frontal car collision and collapse at the scene of incident was brought to the A&E department and sent for an emergency whole-body CT. All of the following are correct regarding blunt cardiac trauma, except
A. Cardiac concussion results in abnormal cardiac enzymes.
B. Traumatic pericardial rupture resulting from blunt chest trauma is rare.
C. Cardiac herniation is a serious complication of pericardial rupture.
D. Traumatic ventricular septal defects affect the muscular portion.
E. Myocardial contusion is associated with cardiac tamponade.
A. Is wrong . Cardiac concussion is the mildest form of injury with no enzymes abnormalities , whereas contusion can lead to elevated enzymes and bilateral pulmonary edema
A 16-year-old girl with a history of recurrent bronchitis undergoes chest X ray. The lungs are clear but there is tracheal deviation to the left, with a focal indentation of the right wall of the trachea. Underlying vascular anomaly is suspected, and the patient undergoes a magnetic resonance imaging scan for further evaluation. All of the following will explain the above Chest X-ray appearance, except:
A. Double aortic arch
B. Right aortic arch with aberrant left subclavian artery and patent ductus arteriosus
C. Aberrant left pulmonary artery
D. heft aortic arch with aberrant right subclavian artery and patent ductus arteriosus
E. Common origin of innominate and left common carotid artery
C. Aberrant left pulmonary artery
Double aortic arch variants and right aortic arch with aberrant left subclavian artery and patent ductus arteriosus are the two most common types of vascular rings which encircle the mediastinal airways. Both these conditions cause leftward deviation of the trachea and indentation of the right tracheal wall visible on the chest X-ray together with a large posterior oesophageal impression visible on oesophagogram. Left aortic arch with aberrant right subclavian artery is the most common vascular anomaly of the aortic arch, but only in the extremely rare association with patent ductus arteriosus will it cause similar appearances.
A less common vascular anomaly, which may cause a similar appearance of the trachea but does not cause any oesophageal indentation, is a common origin of innominate and left common carotid artery. Aberrant left pulmonary artery’ causes posterior tracheal indentation and anterior osophageal impression.
When should dobutamine stress echo be stopped
The heart rate has increased to the target rate of (85% × (200-age))
• New wall motion abnormality is seen
• Blood pressure rises above 240/220mmHg
• Systolic blood pressure falls by 40mmHg
• The patient develops persistent arrhythmias
• The patient becomes too symptomatic to continue the scan
Contraindication for dobutamine stress mri
Hypertension >220/120mmHg
• Unstable angina
• Aortic stenosis (severe)
• Uncontrolled atrial fibrillation
• Hypertrophic cardiomyopathy
• Congestive heart failure
Contraindications to thrombolysis
• Major trauma at presentation
• Lumbar puncture within the last 1 week
• Surgery or CPR within the last 2 weeks
• Upper Gl bleed within the last 3 weeks
• CVA within the last 8 weeks
• Bleeding disorder
• INR > 1.6
• Platelets < 100
• Brain tumour
• Irreversible ischaemia
Almost complete abscence of right ventricle myocardium
Normal tricuspid valve
Leading to isolated right heart failure
I.e. hepatomegaly, jugular vein distension , dyspnea and cyanosis
Uhls anomaly
Endocarditis(iv drug use) cause what valvular pathology
Tricuspid regurgitation
It also causes carcinoid syndrome which affects the right heart and causes right heart dilatation
The most common cause of TR in adults is pulmonary arterial hypertension
Severe pulmonary hypertension
Nodular serpiginous vessels
Pulm arterial calcification with enlargement
Paucity of peripheral pulm vasculature
Eisenmenger syndrome
1.Anterior wall , anterior septum and majority of apex
2. Inferior or inferolateral wall and septum
3. Lateral wall
1.LAD
2. RCA
3. Circumflex
Anything less than 50% of involvement is viable
