Test 3 Flash Review

What is the hallmark of Aortic Dissection?

Intimal flap

The most common location for aortic dissection is:

Ascending aorta

Normal Rt + Lt Common Iliac Diameter

<1.0 cm

At what diameter do the Rt + Lt Common Iliacs become at risk for rupture?

3 cm

What pathology demonstrates a “to and fro” Doppler flow pattern?

Aortic Pseudoaneurysm

Stanford Type A Aortic Dissection

Proximal Aorta affected

Stanford Type B Aortic Dissection

Distal Aorta affected

After how long should the aneurysm sac start to decrease after treatment?

6 months

What is the most common cause of Aortic Aneurysm?

Hypertension and Trauma

Aortic Arch Diameter

<3.5 cm

What branches come off of the transverse aorta?

Innominate, LCCA, & LSA

Ascending Aorta diameter

<3.5 cm

Debakey Aortic Dissection Type 1

Through entire Aorta

Debakey Aortic Dissection Type 2

Of Ascending Aorta

Debakey Aortic Dissection Type 3

Of Descending Aorta

What sign os Sinus of Valsalva aneurysm associated with?

Windsock appearance of ruptured aneurysm

Sinotubular Junction

Where Sinus of Valsalva meets Ascending Aorta

Descending Aorta diameter

<3 cm

Proximal Abdominal Aorta diameter

<3cm

Distal Abdominal Aorta diameter

<1.5 cm

What is the most common aortic disease?

Atherosclerosis w/ HTN

Where is atherosclerosis in the aorta most commonly found?

Distal aorta

What structures cause respiratory findings due to aneurysm impinging on surrounding structures?

Bronchus, trachea, & esophagus

What types of endoleaks are most easily found?

I & III

What artifacts may mimic Aortic dissection?

side lobes, linear reverberation

What cusp is most commonly associated with sinus of Valsalva aneurysm?

RCC

Aortic Atherosclerosis is most commonly associated in:

older smokers with HTN

What is commotion cordis?

Blunt trauma causing cardiac arrest in young athletes

What is the most common cause of cardiac trauma?

motor vehicle accidents

What is the most common cause of a bruised myocardium?

Motor vehicle accidents

What is the most common finding of blunt cardiac trauma?

Segmental WMA’s

Are left or right sided valves more prone to valve injury with blunt trauma?

Left sided valves

What is the most common finding of a non penetrating cardiac trauma?

AoV leaflet injury

TV injury is most often associated with:

RV free wall injury

What chamber is most susceptible to penetrating cardiac trauma?

RV

Where is the needle inserted during a pericardiocentesis?

Subxyphoid region

Where is an LV aneurysm most commonly located?

Apex

What is an LV aneurysm the most often the result of?

Anterior MI

True or False. True Aneurysms expand in systole.

False

What is the most common form of birth defects?

Congenital Heart Defects

The IVS is usually completed by:

6 weeks

Division of the common AV canal into lt and rt orifices occurs by:

fusion of the superior and inferior endocardial cushions

PDA results in a:

Left to right shunt

PDA patency is highly associated with:

rubella during pregnancy, premature birth, & high altitude births

PDA auscultation

Continuous murmur over pulmonic area

SVC oxygen saturation

70%

IVC oxygen saturation

80%

Rt heart (RV + RA) oxygen saturation

75%

RVOT oxygen saturation

75%

LA, LV, Aorta oxygen saturation

95%

LA : Ao ratio

1.4 : 1.0

The most common ASD is:

Ostium Secundum

The least common ASD is:

Sinus Venosus

What ASD is associated with the “T sign” on ultrasound?

Ostium Secundum ASD

What is Sinus Venosus ASD associated with?

PAPVR

ASD auscultation

S2 split

What is the best view to observe ASD’s?

Subcostal

Cryptogenic Stroke

Results from when DVT passes thru PFO (paradoxical emboli)

What is the cause of a floppy septum?

Interatrial pressure differences

Atrial Septal Aneurysm findings:

“Jump rope appearance”, emboli, >1.5 cm in length + excursion

The most common congenital lesion present at birth:

Ventricular Septal Defect

What is the most common type of VSD?

Membranous VSD

Outlet VSD’s straddle the _______________.

Crista Supraventricularis

Crista Supraventricularis separates the _____ from ___________.

RVOT; RV cavity

What are Inlet VSD’s associated with?

Complete endocardial cushion defects

VSD auscultation

Systolic murmur heard along LSB

Eisenmenger’s Complex

VSD, Aortic Dextroposition, PHTN, RVH

Left to Right shunt

Negative contrast effect

Right to Left shunt

Positive contrast effect

Qp : Qs shunt ratio

comparison of the volume of pulmonary flow (Qp) to systemic flow (Qs)

Limitations of Qp:Qs shunt ratio include:

Stenosis & regurgitation

Qp:Qs for ASD

Qp = RVOT

Qs = MV / LVOT

Qp:Qs for VSD

Qp = RVOT / MV

Qs = LVOT

Qp:Qs for PDA

Qp = MV / LVOT

Qs = TV / RVOT

What is endocardial cushion defects associated with?

Down Syndrome

Ebstein’s Anomaly

Atypically displaced TV resulting in RV atrialization

What causes cyanosis in Ebstein’s anomaly?

severe TR / pulm atresia that causes rt to Lt shunt

Ebstein’s anomaly is associated with:

Lithium use during pregnancy

Ebstein’s Anomaly auscultation

systolic sail sound with wide split s1 and loud s2 murmur

Tricuspid Atresia

Congenital absence of TV

The finding always found with Tricuspid Atresia:

ASD

What surgery corrects Tricuspid Atresia?

Fontan Procedure

Parachute Mitral Valve

All chordae attach to a single large papillary muscle

Arcade Mitral Valve

Chordae insert into multiple small papillary muscles

Double Orifice Mitral Valve

Two separate mitral valve openings where all chordae from an orifice attach to one papillary muscle

Valvular pulmonic Stenosis

Most commonly due to valve cusp fusion

Discrete Subaortic Stenosis

A ridge that forms a crescent shaped barrier in the LVOT

What develops in discrete subaortic stenosis?

AI

Subaortic Fibromuscular Ridge

Thickening and narrowing of the LVOT

Supravalvular Aortic Stenosis

Congenital narrowing of the Ascending Aorta

The most common type of of supravalvular aortic stenosis:

Hourglass

What type of supravalvular aortic stenosis is associated with hypoplastic left heart syndrome?

Strand Supravalvular Aortic Stenosis

Where does aortic coarctation occur?

Isthmus (just prox/distal to the ductus arteriosus)

Aortic Coartation is common in:

Turner Syndrome pt’s

Coarctation of the aorta is most commonly associated with:

Bicuspid Aortic Valve

Endocarditis occurs ______ to a coarctation.

Distal

Shine’s complex consists of:

Supravalvular MV ring, parachute MV, discrete Subaortic stenosis, & coarctation

With coarctation, UE to LE BP differs by:

>20 mmHg

Aortic Coarctation CXR findings include:

Rib notching and “3” sign

What is the “sawtooth pattern” associated with?

Aortic Coarctation CW