• Embed Doc
  • Copy Link
  • Readcast
  • Collections
  • CommentGo Back
Download
3 of 11

1. Ventricular Septal Defect
2. Atrial Septal Defect
3. Patent Ductus Arteriosus

CASE 1: Ventricular Septal Defect
1 month old boy; Failure to thrive; CHF

PE: Systolic murmur-low pericardium
Holosystic murmur \u2013extends 2nd heart sound
Soft low pitch early diastolic murmur \u2013 apical area

CXR FINDINGS:
\u2022
Cardiomegaly
\u2022
Inc pulmo bld flow
\u2022
LAE
\u2022
Displacement
of
L
mainstem
bronchus
\u2022
R aortic arch
\u2022
CHF (infants)
CASE 2: Atrial Septal Defect (common in children)
Systolic ejection murmur in
pulmonic region
Parasternal
diastolic
murmur
Mild cardio w/RAE&
RVE
Mild increase Pulmo bld
flow
CASE 3: Patent Ductus arteriosus (common in adults)
2y/o
Failure to thrive CHF
Machinery like murmur in the

pulmonic area
inc pulmo bld flow
Cardiomegaly
Aorta prominent

Prox asc aorta in arch of the
aorta
Focal aortic fil
LAE & LVE
PATENT DUCTUS ARTERIOSUS
CYANOTIC HEART DISEASES
**In cyanotic heart diseases, hyperaerated lungs are
usually seen.
1)Normal blood flow
a) Coarctation
of
the Aorta
CASE 4
\u2022
14
day
old
infant
\u2022
Dyspnea
\u2022
Poor feeding
\u2022
Tachycardia
\u2022
Peripheral
cyanosis
o
Moderate to marked cardiomegaly
o
Pulmo venous congestion
o
Post
stenotic
dil.
of
the
descending aorta
2) Increased blood flow
a) Transposition of Great Arteries
CASE 5
\u2022
Infants of DM
\u2022
Cyanosis
at
birth
\u2022
Acidosis
\u2022
CHF
\u2022
No murmur
\u2022
CXR FINDINGS :
oHyperinflated
lungs
o
Low set HD
o
Narrowed based
o
heart
o
Egg shaped on side
o
Thymic atrophy
o
Cardiomegaly
b)Total Anomalous
Pulmonary Venous
Return
\u2022
N cardiac conf
\u2022
Pulmo
venous/edema
\u2022
Thymic atrophy
\u2022
Low set HD
\u2022
Occ\u2019l PE
\u2022
Hemodiaphragm
\u2022
Snowman\u2019s sign
3) Decreased blood flow
a) Tetralogy of Fallot
CASE 7
\u2022
6 mos old
\u2022
Cyanosis
\u2022
Dyspnea \u2013 1st sign
CYANOTIC CONGENITAL HEART DISEASES
3 of 11
\u2022
Loud
ejection
murmur- L sternal
angle
\u2022
CXR FINDINGS :
o
Boot
shaped
heart
o
Concave MPA
o
Dec hilar and
central pulmo
vessels
oHyperexpanded hyperlucent lungs
o
Thymic atrophy
o
Rt aortic arch
b) Tricuspid Valve Atresia
Case 8
\u2022
Dyspnea
\u2022
Jugular pulsations
\u2022
Loud murmur along the L sternal border
\u2022
Mild cardiomegaly
\u2022
Dec pulmo bld flow
\u2022
Hyperlucent lungs
\u2022
Concave MPA
\u2022
Rt aortic arch
\u2022
RAE and RVE
c) Ebstein's Anomaly
CXR findings:
\u2022
Marked cardio
\u2022
RAE w/ globular
cardiac silhouette
\u2022
Dec pulmo bld
flow
\u2022
Boxed heart
\u2022
Any benign/malignant neoplasm arising primarily
from the myocardium or w/in a cardiac chamber
\u2022
Approximately 70% are benign and 30% are
malignant
\u2022
Metastatic tumors are not classified as cardiac
tumors
BENIGN
MALIGNANT
Myxoma
Angisarcoma
Lipoma
Rhabdomyosarcoma
Papillary Fibroadenoma
Mesothelioma
Hemangioma
Fibrosarcoma
Mesothelioma
Lymphoma
Fibroma
Osteosarcoma
ACYANOTIC
Increase PBF
RVH
LVH / CVH
Atrial Septal Defect
Ventricular Septal Defect
L to R Shunt w/ PHPN
Patent Ductus Arteriosus
PAPVR
AVSD
CYANOTIC
Dec PBF
RVH
LVH
LVH / CVH
VSD w/ PS
Tricuspid Atresia
TA w/ Hypoplastic
PAs
Tetralogy of Fallot
Pulmonary Atresia
Hypolastic RV
TGA w/ PS
Ebstein\u2019s Anomaly
Eisenmenger
Single Ventricle w/
P S
CYANOTIC
Increase PBF
RVH
LVH / CVH
TAPVR
TGA w/ VSD
Hypoplastic
Syndrome
Single Ventricle
PVOD
Truncus Arteriousus
TGA
Bidirectional Shunt
CARDIAC TUMORS
3 of 11
Teratoma
Thymoma
Granular cell tumor
Neurogenic Sarcoma
Neurofibroma
Leiomyosarcoma
Lympahngioma
Liposarcoma
Rhabdomyoma
Synovial sarcoma
\u2022Epicardium, the sheath of tissue that covers the heart
\u2022
Myocardium, the muscles of the heart wall
\u2022
Endocardium, the membrane that lines the cavities
of the heart
Benign Tumors
Myxoma (most common)
\u2022
Morphology:
o
Usually PEDUNCULATED w/ short, broad-
based attachment
o

Characteristically polypoid, project into cardiac chamber and about 5+6 cm in diameter

o
Gelatinous/ mucoid texture and covered w/
endothelium
o
Arises from endocardium as small, uniform
cells in myxomatous stroma
o
Rarely metastasizes
\u2022
Location
o
LA 75% - most common location
o
RA 20%
o
Atrial myxomas usually arises from atrial
septum
o
Ventricles: <10%
o
Multicentric: 5%
o
Valve: rare
o
Myxoma of left atrium
Lipoma
\u2022
Well-Encapsulated Tumors, Usually Found
Incidentally
\u2022
Consist Of Mature Fat Cells
\u2022

Most commonly occur in ATRIAL SEPTUM as part of lipomatous hyperthropy of the interatrial septum

\u2022
Incidental tumors should probably be resected
\u2022
PERICARDIAL LIPOMA
\u2022
LIPOMATOUS
INFILTRATION
OF
INTERATRIAL
SEPTUM
NOTES:

Fat \u2013 bright on T1 and T2 CSF \u2013 white on T2, black on TI

Malignant Tumors
Sarcoma
\u2022
Malignant tumor w/ wide
variety
of
types,
originating
from
mesenchyme
\u2022
Subtype
include,

angisarcoma,
rhabdomyosarcoma,
fibrosarcoma,
osteosarcoma,
neutrogenic

sarcoma,
leiomyosarcoma,
liposarcoma

and
synovial sarcoma
\u2022
MC:RA & in mid-adulthood
\u2022
Operation indicated to obtain accurate dx
o
Prognosis is poor, as most px have distant
metastases at presentation
o
Adjuvant therapy may have some roles
NOTES:
Most common location in
both
Sarcoma
and
Lymphoma:RA
Papillary fibroelastomas
\u2022
Would seem to be approx. equivalent to Lipoma
in prevalence
\u2022
Over 90% occur on cardiac valves, making them
the commonest neoplasm of the valves
\u2022
Many are asymptomatic, and Sx if present are
usually related to embolic events
\u2022
There appears to be slight predilection for left-
sided valves
\u2022
On MRI- it appears as a HYPO-INTENSE mobile
mass
of 00

Leave a Comment

You must be to leave a comment.
Submit
Characters: ...
You must be to leave a comment.
Submit
Characters: ...