Pathology-Cardiovascular

CXR

still plays an important roll in the diagnosis and management of cardiovascular disease

\-heart size and shape

\-great vessel and vascular changes within the lung fields

Factors that the technologist can control

1. Degree of inspiration
2. Correct positioning
3. Geometric factors
4. Technical factors

Modalities used in Cardiac imaging

1. Echo
2. Nuclear Medicine
3. CT
4. MRI
5. Angiography

Embryonic Circulation

fetal oxygen supply

\-2 openings

Foramen Ovale

opening between right and left atria

Ductus Arteriosis

opening between pulmonary trunk and aorta

Patent Ductus Arteriosis

opening does not close

\-serves to shunt blood from pulmonary trunk into the systemic circulation during intrauterine life

\-bypass pulmonary circulation

\-echo is modality of choice

\-will have low oxygenated blood going through the body

\-marked cardiomegaly with dilation of the pulmonary trunk

\-pulmonary plethora

Coarctation of the Aorta

narrowing or constricting of the aorta at the junction where the ductus arteriosis closes after birth

\-most commonly occurs just inferior to the branching of the blood vessels to thee head and arms

\-decreased blood flow to lower regions

\-echo is modality of choice

Radiographic Appearance of Coarctation of the Aorta

2 bulges and rib notching

What are the 2 septal defects?

Atrial and Ventricular

Atrial Septal Defect

fistula between right and left atria

\-due to the lack of closure of the foramen ovale

\-most common

\-treatment: angiography

Ventricular Septal Defect

more serious

Tetralogy of Fallout

most common cause of cyanotic congenital heart disease

\-heart is boot-shaped

\-echo is modality of choice

\-treatment: surgery

\-heart murmur

Problems of Tetralogy of Fallout

1. Narrowing of the pulmonary valve
2. Thickening of wall of right ventricle
3. Displacement of aorta over ventricular septal defect
4. Ventricular septal defect-opening between the right and left ventricle

Valvular Heart Disease

Mitral and Aortic Valve Stenosis

\-affects volume of blood, not rate at which it is pumped

Mitral Valve Stenosis

between left atrium and left ventricle

\-regurgitation

Aortic Valve Stenosis

between left ventricle and aorta

\-stenosis

Congestive Heart Failure

the inability of the heart to propel blood at a sufficient rate and volume to provide adequate supply of oxygenated blood to the body tissue

\-cardiomegaly

\-with “whiteout” appearance

\-pulmonary circuit overload

\-decreased both rate and volume of blood pumped

Cardiomegaly

enlarged heart

\-no more than 50 % of total measurement

Atherosclerosis

“hardening of the arteries”

\-marked by thickening, hardening and loss of elasticity in the arterial wall

\-arteries affected

\-aorta, cerebral, and coronary arteries most common

\-caused by coronary artery disease

Coronary Artery Disease

narrowing of the coronary arteries caused oxygen deprivation of the myocardium

\-due to fatty material on the inner arterial wall

\-temporary oxygen insufficiency causes angina pectoris

\-nitroglycerin

Coronary Artery Disease-Angiography

considered the definitive test for determining the presence and severity of coronary artery disease

\-right coronary artery

\-left coronary artery

\-left anterior descending

\-left coronary circumflex branch

Myocardial Infarction

occlusion of a coronary artery deprives an area of the heart its blood supply and leads to death in muscle cells

\-results from CAD

\-diagnosis: EKG, blood work

Maintenance Imaging

nuclear medicine scanning are the major non-invasive ways to assess blood flow to the heart

\-SPECT-uses CT and radioactive material (functional test)

Aneurysm

localized dilatation of an artery, ballooning or outpouching of a vessel wall

\-wall may be weakened by atherosclerotic disease, trauma, infection, or congenital defect

\-75% occur in the aorta

\-90% of those occur below the level of the renal arteries

\-3 types

Saccular Aneurysm (Berry)

involves only one side of the arterial wall

Fusiform Aneurysm

involves both sides of arterial wall

Dissecting Aneurysm

intima layer pulled away

Thrombus

blood clot that forms in a vein

\-usually in lower extremities

Embolus

movement of the blood clot

\-can be fatel

\-lower extremities

Deep Venous Thrombosis

blood clots within a vein

\-tends to form where blood flow is slow

\-common in lower extremities

\-US is commonly used

\-major complication: PE

\-treatment: IVC filter