CARDIAC RADIOLOGY

Timothy P. Morris, D.O., F.A.C.C.

www.sjhg.org

CARDIAC RADIOLOGY

• HISTORY– 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– PA– AP– LATERAL– RAO– LAO

CARDIAC RADIOLOGY

• CHEST PA LANDMARKS– SUBCLAVIAN– AORTIC NOTCH– PULMONARY ARTERY– LEFT ATRIUM, LEFT VENTRICLE– AZYGOS– ASCENDING AORTA– RIGHT ATRIUM

CARDIAC RADIOLOGYNORMAL CHEST X-RAY

Dextrocardia with Situs Inversus

CARDIAC RADIOLOGY

• LANDMARKS LATERAL VIEW– RIGHT VENTRICLE– POSTERIOR WALL LEFT VENTRICLE– LEFT ATRIUM– PERICARDIUM– VALVE RINGS

CXR Lateral

CARDIAC RADIOLOGY

• MEASURING CARDIAC SIZE

• ATRIAL SIZE

• VENTRICULAR SIZE

CARDIAC RADIOLOGYLEFT HEART ENLARGEMENT

CARDIAC RADIOLOGYRIGHT HEART ENLARGEMENT

CARDIAC RADIOLOGY

• PULMONARY VASCULATURE– PULMONARY ARTERY HYPERTENSION– PULMONARY VENOUS HYPERTENSION– PULMONARY EDEMA

• DECREASED PULMONARY FLOW– PULMONARY STENOSIS– PNEUMOTHORAX

CARDIAC RADIOLOGYSEVERE PULONARY HYPERTENSION

CARDIAC RADIOLOGYCHRONIC CONGESTIVE HEART

FAILURE

CARDIAC RADIOLOGYCHRONIC CONGESTIVE HEART

FAILURE LATERAL

CARDIAC RADIOLOGYACUTE PULMONARY EDEMA

CARDIAC RADIOLOGYKERLEY B LINES

CARDIAC RADIOLOGYCONGESTIVE HEART FAILURE

CARDIAC RADIOLOGYPULMONARY FIBROSIS SECONDARY

TO AMIODARONE

CARDIAC RADIOLOGYPULMONARY STENOSIS

CARDIAC RADIOLOGYTENSION 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

• PERICARDIAL EFFUSION

• PERICARDIAL CONSTRICTION

• PERICARDIAL NEOPLASM

• PERICARDIAL CYST

• CONGENITAL ANOMALIES

CARDIAC RADIOLOGYPOST-PERICARDOTOMY SYNDROME

Pericardial Cyst

Pneumoperitoneum

CARDIAC RADIOLOGY

• VALVULAR ABNORMALITIES– AORTIC STENOSIS– MITRAL STENOSIS– AORTIC REGURGITATION– MITRAL REGURGITATION

Aortic Stenosis PA View

Aortic Stenosis Lateral View

CARDIAC RADIOLOGYAORTIC STENOSIS-POST STENOTIC

AORTIC DILATATION

CARDIAC RADIOLOGYMITRAL STENOSIS

Mitral Stenosis Lateral View

CARDIAC RADIOLOGYPRE AND POST AVR FOR AR

CARDIAC RADIOLOGYMITRAL REGURGITATION

Prosthetic Valves

CARDIAC RADIOLOGY

• CONGENITAL ABNORMALITIES– ACYANOTIC

• ASD (SECUNDUM)

• COARCTATION OF THE AORTA

• VSD

– CYANOTIC• TETRALOGY OF FALLOT

• EBSTEIN’S ANOMALY

• PDA

CARDIAC RADIOLOGYCOARCTATION OF THE AORTA/RIB

NOTCHING

Aortic Coarctation CT Scan

CARDIAC RADIOLOGYFOUR CHAMBER ENLARGEMENT / VSD

CARDIAC RADIOLOGYCONGESTIVE HEART FAILURE / VSD

CARDIAC RADIOLOGYRIGHT HEART FAILURE / ASD

CARDIAC RADIOLOGYRIGHT SIDED ARCH/TETROLOGY OF

FALOT

CARDIAC RADIOLOGYPULMONARY HYPERTENSION / PDA

Aortic Dissection

Thoracic Aortic Stent Graft

Biventricular AICD

MSCT Scan

Coronary Artery DiseaseMSCT Angiography

Coronary Artery DiseaseCardiac Catheterization

CARDIAC RADIOLOGY

• SUMMARY

– CLINICAL HISTORY IS IMPORTANT– LOOK AT THE ENTIRE CHEST– LOOK AT ALL BONEY STRUCTURES– ALLOW FOR ABNORMALITIES

SECONDARY TO BODY HABITUS