Cardiology Quiz: Heart Conditions
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Cardiology Quiz: Heart Conditions

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@InvulnerableRetinalite3991

Questions and Answers

In HOCM, what type of contractility can be seen?

Good or hyperdynamic contractility

What is the characteristic of ARVD on MRI?

High T2W1 with dilated right ventricle

What is Uhl's anomaly characterized by?

Paper thin right ventricle with complete absence of musculature

What is the cause of ischemia, infarction, arrhythmia, and even death in myocardial bridging?

<p>Length of coronary artery taken an intramyocardial course</p> Signup and view all the answers

What is the most common cardiac mass?

<p>Thrombus</p> Signup and view all the answers

What is the origin of two left-sided bronchial arteries?

<p>Aorta</p> Signup and view all the answers

In which percentage of cases does the artery to the SA node arise from the left circumflex artery?

<p>40%</p> Signup and view all the answers

What is the characteristic of pericardial thickening in constrictive pericarditis?

<p>Thickening &gt; 4 mm</p> Signup and view all the answers

What percentage of myxomas arise from the interatrial septum near the fossa ovalis?

<p>75%</p> Signup and view all the answers

In which age range do most myxoma patients present?

<p>30-60 years</p> Signup and view all the answers

What is the average size of a myxoma at presentation?

<p>6 cm</p> Signup and view all the answers

What percentage of myxomas are sessile?

<p>25%</p> Signup and view all the answers

In complete left-sided absence of a defect, where is the heart shifted?

<p>To the left</p> Signup and view all the answers

What is a common association of foraminal left-sided defects?

<p>All of the above</p> Signup and view all the answers

Which part of the myocardium is uppermost in a standard short axis view?

<p>Anterior wall</p> Signup and view all the answers

What is a possible complication of myxoma?

<p>Both A and B</p> Signup and view all the answers

What is the likely primary diagnosis of a 40-year-old man with pericardial metastases and pericardial effusion?

<p>Melanoma</p> Signup and view all the answers

What is the characteristic MRI feature of metastases from melanoma?

<p>High signal on T1-weighted imaging</p> Signup and view all the answers

What is the most likely feature of a left atrial myxoma on MRI?

<p>Hypointense relative to myocardium on T1-weighted images</p> Signup and view all the answers

How does a left atrial myxoma appear on steady-state free precession (SSFP) images?

<p>Hypointense to blood pool and hyperintense to myocardium</p> Signup and view all the answers

What is the best way to demonstrate the prolapse of a left atrial myxoma through the mitral valve?

<p>Cine gradient echo imaging</p> Signup and view all the answers

What is the purpose of delayed contrast-enhanced cardiovascular MR (DE-CMR)?

<p>To assess cardiac viability</p> Signup and view all the answers

What is a characteristic feature of a cardiac tumor on MRI?

<p>Heterogenous appearance on most MRI sequences</p> Signup and view all the answers

What can cause varying enhancement patterns in a left atrial myxoma on MRI?

<p>All of the above</p> Signup and view all the answers

What is the Agatston scoring system used for?

<p>Quantifying coronary calcification</p> Signup and view all the answers

What is the most likely unifying diagnosis for a patient with cardiomegaly, multiple rib fractures, and right lower lobe consolidation?

<p>Chronic alcohol abuse</p> Signup and view all the answers

What is the likely diagnosis for a patient with exertional dyspnoea, left ventricular dysfunction, and focal hypokinesis in the anteroseptal wall?

<p>Myocardial infarction</p> Signup and view all the answers

What is the most likely diagnosis for a patient with a mobile echogenic mass attached to the intra-atrial septum by a stalk?

<p>Cardiac myxoma</p> Signup and view all the answers

What is the likely cause of a patient's symptoms if they have focal hypokinesis in the anteroseptal wall?

<p>Myocardial infarction</p> Signup and view all the answers

What is the differential diagnosis of a pedunculated intracardiac lesion?

<p>Atrial myxoma and papillary fibroelastoma</p> Signup and view all the answers

What is the likely diagnosis for a patient with left ventricular dysfunction and delayed enhanced images showing increased signal in the subendocardium?

<p>Myocardial infarction</p> Signup and view all the answers

What is the significance of the delayed enhanced images in the cardiac MRI?

<p>It shows increased signal in the subendocardium</p> Signup and view all the answers

What is characterized by the replacement of the myocardium by fatty and fibrous tissue?

<p>Arrhythmogenic right ventricular dysplasia</p> Signup and view all the answers

Which of the following is a symptom of Arrhythmogenic right ventricular dysplasia?

<p>Syncopal episodes</p> Signup and view all the answers

What is the advantage of MRI over echocardiography in diagnosing ARVD?

<p>MRI shows evidence of fat and fibrous tissue</p> Signup and view all the answers

What characteristic makes a diagnosis of a true ventricular aneurysm more likely than a false aneurysm?

<p>An aneurysm that protruded only in systole</p> Signup and view all the answers

What is the characteristic of a false aneurysm?

<p>Protrudes in diastole and systole</p> Signup and view all the answers

What is the primary reason for a 57-year-old man with diabetes mellitus to undergo coronary artery bypass surgery?

<p>To relieve anterior chest pain on minimal exertion</p> Signup and view all the answers

Which of the following native grafts is most appropriate for bypassing the left anterior descending artery?

<p>Left internal mammary artery</p> Signup and view all the answers

What is the indication for coronary artery bypass surgery in the 57-year-old man with diabetes mellitus?

<p>All of the above</p> Signup and view all the answers

Study Notes

Cardiac Conditions

  • HOCM (Hypertrophic Obstructive Cardiomyopathy): may have good or hyperdynamic contractility with SAM (Systolic Anterior Motion) partially obstructing the subaortic region.
  • Left atrial enlargement is seen in rheumatic aortic stenosis, but not in calcific aortic stenosis.
  • Arrhythmogenic right ventricular dysplasia: characterized by fibro-fatty replacement of right ventricular myocardium, causing sudden death in young adults (more in males).
  • Uhl's anomaly: a rare condition with a paper-thin right ventricle and complete absence of musculature.
  • Myocardial bridging: a condition where a length of coronary artery (usually LAD) takes an intramyocardial course, causing ischemia, infarction, arrhythmia, and even death.

Cardiac Tumors

  • Thrombus (non-enhancing): most common cardiac mass.
  • Metastasis: most common enhancing cardiac mass.
  • Angiosarcoma: most common primary malignant cardiac tumor.
  • Myxoma: most common primary cardiac tumor in adults, typically villous, pedunculated tumors, with only 25% seen as a sessile mass.

Cardiac Imaging

  • Myocardial perfusion imaging: adenosine is the drug of choice, but not given in asthma patients (dobutamine is given).
  • Pericardial thickening: > 4 mm is seen in constrictive pericarditis, but normal in restrictive cardiomyopathy (normal thickness is 2 mm).
  • Cardiac MRI:
    • Myxoma: appears hypointense relative to myocardium on T1-weighted images.
    • Myocardial infarction: appears as purely subendocardial delayed hyperenhancement in a recognized vascular territory.

Other

  • Partial anomalous pulmonary venous return (PAPVR): may cause strangulation and have the appearance of a large cardiac silhouette seen in pericardial effusions.
  • Artery to SA node: arises from right coronary artery in 60% cases and from left circumflex artery in 40% of cases.
  • Coronary artery bypass surgery: the most appropriate native graft for bypassing the left anterior descending artery is the left internal mammary artery.

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Description

Test your knowledge on various heart conditions including HOCM, aortic stenosis, arrythmogenic right ventricular dysplasia, and Uhl's anomaly.

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