Download CARDIAC RADIOLOGY AORTIC STENOSIS

CARDIAC RADIOLOGY
Timothy P. Morris, D.O., F.A.C.C.
www.sjhg.org
CARDIAC RADIOLOGY
• HISTORY
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Williams 1899
Sones 1959
CT scanner 1980’s
Cine CT scanner 1984
MRI
ECHO
Multi-slice CT Scanner (64 slice)
CARDIAC RADIOLOGY
• PLAIN CHEST X-RAY
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PA
AP
LATERAL
RAO
LAO
CARDIAC RADIOLOGY
• CHEST PA LANDMARKS
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SUBCLAVIAN
AORTIC NOTCH
PULMONARY ARTERY
LEFT ATRIUM, LEFT VENTRICLE
AZYGOS
ASCENDING AORTA
RIGHT ATRIUM
CARDIAC RADIOLOGY
NORMAL CHEST X-RAY
Dextrocardia with Situs Inversus
CARDIAC RADIOLOGY
• LANDMARKS LATERAL VIEW
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RIGHT VENTRICLE
POSTERIOR WALL LEFT VENTRICLE
LEFT ATRIUM
PERICARDIUM
VALVE RINGS
CXR Lateral
CARDIAC RADIOLOGY
• MEASURING CARDIAC SIZE
• ATRIAL SIZE
• VENTRICULAR SIZE
CARDIAC RADIOLOGY
LEFT HEART ENLARGEMENT
CARDIAC RADIOLOGY
RIGHT HEART ENLARGEMENT
CARDIAC RADIOLOGY
• PULMONARY VASCULATURE
– PULMONARY ARTERY HYPERTENSION
– PULMONARY VENOUS HYPERTENSION
– PULMONARY EDEMA
• DECREASED PULMONARY FLOW
– PULMONARY STENOSIS
– PNEUMOTHORAX
CARDIAC RADIOLOGY
SEVERE PULONARY HYPERTENSION
CARDIAC RADIOLOGY
CHRONIC CONGESTIVE HEART
FAILURE
CARDIAC RADIOLOGY
CHRONIC CONGESTIVE HEART
FAILURE LATERAL
CARDIAC RADIOLOGY
ACUTE PULMONARY EDEMA
CARDIAC RADIOLOGY
KERLEY B LINES
CARDIAC RADIOLOGY
CONGESTIVE HEART FAILURE
CARDIAC RADIOLOGY
PULMONARY FIBROSIS SECONDARY
TO AMIODARONE
CARDIAC RADIOLOGY
PULMONARY STENOSIS
CARDIAC RADIOLOGY
TENSION PNEUMOTHORAX
CARDIAC RADIOLOGY
• CALCIFICATION
– MYOCARDIAL
• LV ANEURYSM
– PERICARDIAL
• RV, RA, AV GROOVE
– VALVULAR
– VESSELS
– ANNULAR
Chronic Restrictive Pericarditis
Chronic Restrictive Pericarditis
Pericardial Calcification CT Scan
CARDIAC RADIOLOGY
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PERICARDIAL EFFUSION
PERICARDIAL CONSTRICTION
PERICARDIAL NEOPLASM
PERICARDIAL CYST
CONGENITAL ANOMALIES
CARDIAC RADIOLOGY
POST-PERICARDOTOMY SYNDROME
Pericardial Cyst
Pneumoperitoneum
CARDIAC RADIOLOGY
• VALVULAR ABNORMALITIES
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AORTIC
MITRAL
AORTIC
MITRAL
STENOSIS
STENOSIS
REGURGITATION
REGURGITATION
Aortic Stenosis PA View
Aortic Stenosis Lateral View
CARDIAC RADIOLOGY
AORTIC STENOSIS-POST STENOTIC
AORTIC DILATATION
CARDIAC RADIOLOGY
MITRAL STENOSIS
Mitral Stenosis Lateral View
CARDIAC RADIOLOGY
PRE AND POST AVR FOR AR
CARDIAC RADIOLOGY
MITRAL REGURGITATION
Prosthetic Valves
CARDIAC RADIOLOGY
• CONGENITAL ABNORMALITIES
– ACYANOTIC
• ASD (SECUNDUM)
• COARCTATION OF THE AORTA
• VSD
– CYANOTIC
• TETRALOGY OF FALLOT
• EBSTEIN’S ANOMALY
• PDA
CARDIAC RADIOLOGY
COARCTATION OF THE AORTA/RIB
NOTCHING
Aortic Coarctation CT Scan
CARDIAC RADIOLOGY
FOUR CHAMBER ENLARGEMENT / VSD
CARDIAC RADIOLOGY
CONGESTIVE HEART FAILURE / VSD
CARDIAC RADIOLOGY
RIGHT HEART FAILURE / ASD
CARDIAC RADIOLOGY
RIGHT SIDED ARCH/TETROLOGY OF
FALOT
CARDIAC RADIOLOGY
PULMONARY HYPERTENSION / PDA
Aortic Dissection
Thoracic Aortic Stent Graft
Biventricular AICD
MSCT Scan
Coronary Artery Disease
MSCT Angiography
Coronary Artery Disease
Cardiac Catheterization
CARDIAC RADIOLOGY
• SUMMARY
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CLINICAL HISTORY IS IMPORTANT
LOOK AT THE ENTIRE CHEST
LOOK AT ALL BONEY STRUCTURES
ALLOW FOR ABNORMALITIES
SECONDARY TO BODY HABITUS