Podcast
Questions and Answers
In HOCM, what type of contractility can be seen?
In HOCM, what type of contractility can be seen?
- Good or hyperdynamic contractility (correct)
- Only hyperdynamic contractility
- Only good contractility
- No contractility
What is the characteristic of ARVD on MRI?
What is the characteristic of ARVD on MRI?
- High T2W1 with dilated right ventricle (correct)
- Low T2W1 with dilated right ventricle
- Low T2W1 with dilated left ventricle
- High T2W1 with dilated left ventricle
What is Uhl's anomaly characterized by?
What is Uhl's anomaly characterized by?
- Paper thin left ventricle with complete absence of musculature
- Thickened right ventricle with complete absence of musculature
- Thickened left ventricle with complete absence of musculature
- Paper thin right ventricle with complete absence of musculature (correct)
What is the cause of ischemia, infarction, arrhythmia, and even death in myocardial bridging?
What is the cause of ischemia, infarction, arrhythmia, and even death in myocardial bridging?
What is the most common cardiac mass?
What is the most common cardiac mass?
What is the origin of two left-sided bronchial arteries?
What is the origin of two left-sided bronchial arteries?
In which percentage of cases does the artery to the SA node arise from the left circumflex artery?
In which percentage of cases does the artery to the SA node arise from the left circumflex artery?
What is the characteristic of pericardial thickening in constrictive pericarditis?
What is the characteristic of pericardial thickening in constrictive pericarditis?
What percentage of myxomas arise from the interatrial septum near the fossa ovalis?
What percentage of myxomas arise from the interatrial septum near the fossa ovalis?
In which age range do most myxoma patients present?
In which age range do most myxoma patients present?
What is the average size of a myxoma at presentation?
What is the average size of a myxoma at presentation?
What percentage of myxomas are sessile?
What percentage of myxomas are sessile?
In complete left-sided absence of a defect, where is the heart shifted?
In complete left-sided absence of a defect, where is the heart shifted?
What is a common association of foraminal left-sided defects?
What is a common association of foraminal left-sided defects?
Which part of the myocardium is uppermost in a standard short axis view?
Which part of the myocardium is uppermost in a standard short axis view?
What is a possible complication of myxoma?
What is a possible complication of myxoma?
What is the likely primary diagnosis of a 40-year-old man with pericardial metastases and pericardial effusion?
What is the likely primary diagnosis of a 40-year-old man with pericardial metastases and pericardial effusion?
What is the characteristic MRI feature of metastases from melanoma?
What is the characteristic MRI feature of metastases from melanoma?
What is the most likely feature of a left atrial myxoma on MRI?
What is the most likely feature of a left atrial myxoma on MRI?
How does a left atrial myxoma appear on steady-state free precession (SSFP) images?
How does a left atrial myxoma appear on steady-state free precession (SSFP) images?
What is the best way to demonstrate the prolapse of a left atrial myxoma through the mitral valve?
What is the best way to demonstrate the prolapse of a left atrial myxoma through the mitral valve?
What is the purpose of delayed contrast-enhanced cardiovascular MR (DE-CMR)?
What is the purpose of delayed contrast-enhanced cardiovascular MR (DE-CMR)?
What is a characteristic feature of a cardiac tumor on MRI?
What is a characteristic feature of a cardiac tumor on MRI?
What can cause varying enhancement patterns in a left atrial myxoma on MRI?
What can cause varying enhancement patterns in a left atrial myxoma on MRI?
What is the Agatston scoring system used for?
What is the Agatston scoring system used for?
What is the most likely unifying diagnosis for a patient with cardiomegaly, multiple rib fractures, and right lower lobe consolidation?
What is the most likely unifying diagnosis for a patient with cardiomegaly, multiple rib fractures, and right lower lobe consolidation?
What is the likely diagnosis for a patient with exertional dyspnoea, left ventricular dysfunction, and focal hypokinesis in the anteroseptal wall?
What is the likely diagnosis for a patient with exertional dyspnoea, left ventricular dysfunction, and focal hypokinesis in the anteroseptal wall?
What is the most likely diagnosis for a patient with a mobile echogenic mass attached to the intra-atrial septum by a stalk?
What is the most likely diagnosis for a patient with a mobile echogenic mass attached to the intra-atrial septum by a stalk?
What is the likely cause of a patient's symptoms if they have focal hypokinesis in the anteroseptal wall?
What is the likely cause of a patient's symptoms if they have focal hypokinesis in the anteroseptal wall?
What is the differential diagnosis of a pedunculated intracardiac lesion?
What is the differential diagnosis of a pedunculated intracardiac lesion?
What is the likely diagnosis for a patient with left ventricular dysfunction and delayed enhanced images showing increased signal in the subendocardium?
What is the likely diagnosis for a patient with left ventricular dysfunction and delayed enhanced images showing increased signal in the subendocardium?
What is the significance of the delayed enhanced images in the cardiac MRI?
What is the significance of the delayed enhanced images in the cardiac MRI?
What is characterized by the replacement of the myocardium by fatty and fibrous tissue?
What is characterized by the replacement of the myocardium by fatty and fibrous tissue?
Which of the following is a symptom of Arrhythmogenic right ventricular dysplasia?
Which of the following is a symptom of Arrhythmogenic right ventricular dysplasia?
What is the advantage of MRI over echocardiography in diagnosing ARVD?
What is the advantage of MRI over echocardiography in diagnosing ARVD?
What characteristic makes a diagnosis of a true ventricular aneurysm more likely than a false aneurysm?
What characteristic makes a diagnosis of a true ventricular aneurysm more likely than a false aneurysm?
What is the characteristic of a false aneurysm?
What is the characteristic of a false aneurysm?
What is the primary reason for a 57-year-old man with diabetes mellitus to undergo coronary artery bypass surgery?
What is the primary reason for a 57-year-old man with diabetes mellitus to undergo coronary artery bypass surgery?
Which of the following native grafts is most appropriate for bypassing the left anterior descending artery?
Which of the following native grafts is most appropriate for bypassing the left anterior descending artery?
What is the indication for coronary artery bypass surgery in the 57-year-old man with diabetes mellitus?
What is the indication for coronary artery bypass surgery in the 57-year-old man with diabetes mellitus?
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.
