Radiographic Pathology of the Cardiovascular System PDF

RAD 311 Radiographic Pathology Reham Garout [email protected] Marketing Department Mon. Feb. 21. 2018 Learning objectives Identify common Cardiovascular system pathologies Demonstrate the pathological characteristics of CVS on radiograp...

RAD 311 Radiographic Pathology Reham Garout [email protected] Marketing Department Mon. Feb. 21. 2018 Learning objectives Identify common Cardiovascular system pathologies Demonstrate the pathological characteristics of CVS on radiographic appearances Lecture 6 Cardiovascular system Recap - Anatomy Heart The heart is assessed by means of the cardio- thoracic ratio (CTR). CTR = Cardiac width : Thoracic width Heart size should be less than 50% of total diameter of thorax CTR > 50% is abnormal (cardiomegaly) – PA view only Heart The hemidiaphram do not represent the lowest point of the lungs. Congenital and hereditary diseases Dextrocardia A condition in which the heart is pointed toward the right side of the chest. Normally, the heart points toward the left. The condition is present at birth (congenital) 8 Congenital and hereditary diseases Dextrocardia usually causes no symptoms. Diagnosis: by ECG or imaging (CXR). 9 Congenital and hereditary diseases Septal defect A defect either in the ventricular or atrial septum that allows the blood to be shunted between the two chambers. A hole can vary in size Diagnosis: Color Doppler echocardiography is the imaging method of choice - CXR Appearance: In X-ray the LT atrium/ ventricle is enlarged, pulmonary vascular markings are increased, and pleural effusions may be present. Treatment: may close on its own or may require surgery Septal defect ventricle is enlarged Septal defect Degenerative diseases Atherosclerosis Affects the major arteries of the body. it is a serious condition where arteries become clogged with fatty substances called plaques, or atheroma (fibrofatty plaques) Sometimes the slow narrowing allows enough time for collateral vessels formation to maintain blood supply Angiography is used for diagnosis and treatment Also, CT angio, MRI, doppler US collateral vessels formation to maintain blood supply Degenerative diseases Coronary artery disease (CAD) caused by plaque buildup in the walls of the arteries that supply blood to the heart As the blood supply decreases it will result in ischemia Ischemia is local and temporary impairment of blood circulation Infarction is tissue death or necrosis due to cut of blood supply to the affected area. Degenerative diseases CAD is the leading cause of death in the United States MRI, CT and NM , angiography used for diagnosis Treatment: drugs, cath lab (bypass graft ) Degenerative diseases Myocardial infarction (MI) This happens when blood flow to the heart muscle is blocked. Signs: chest pain radiate to neck and left arm, shortness of breath, sweating and nausea Cardiac angio is important for diagnosis and therapy for stenotic or occluded heart vessel Thrombolytic therapy can also be used within of onset of MI or Percutaneous transluminal coronary angioplasty PCTA Degenerative diseases Aneurysms Is a ballooning of vessel wall resulting from atherosclerosis disease, trauma, infection, or congenital defect that can occur anywhere. Ruptured aneurysms causes Immediate mortality Thoracic aorta aneurysm occur from congenital, or blunt trauma. Abdominal aorta aneurysm (AAA) might be asymptomatic Diagnosis: CT, MRI, and ultrasonography are helpful in assessing the size and extent of the aneurysm Treatment: clip, stent, coils Degenerative diseases Venous thrombosis Formation of blood clots within the vein Commonly form in the veins of lower extremities and results in slowing the blood flow to the heart Leg muscles contraction helps assists with blood retune. Thus postoperative and bedfast patient are more prone to this disorder Filters can be placed under fluoroscopy in the IVC to prevent these clots from reaching lungs and kidneys. Diagnosis: US and venography Treatment: anticoagulant or thrombolytic therapy Degenerative diseases Pulmonary emboli (PE) Occur when a clot become lodged in pulmonary artery. Mostly comes from thrombus originating in lower extremity that migrates to lungs resulting in obstruction of blood supply. Decreased blood supply will lead to acute respiratory distress, heart failure or cardiogenic shock. Diagnosis: angiogram and NM (ventilation & perfusion) and CT Treatment: thrombolytic therapy as Tissue plasminogen activator (tPA) or Blood thinners (anticoagulants). Congestive Heart failure is a long-term condition that happens when the heart can't pump blood well enough to give the body a normal supply. Blood and fluids collect in lungs and legs over time Symptoms: SOB, Fatigue, Swelling in the legs and feet, Rapid or irregular heartbeat. Reduced ability to exercise. Wheezing. Chronic cough or a cough that brings up white or pink mucus with spots of blood and Swelling of the belly area Congestive Heart Failure Diagnosis: CXR, echocardiogram and ECG Radiographically, the heart is enlarged, pleural effussion and the hilar region of the lungs is congested with increased vascular markings Heart is enlarged, pulmonary vasculature prominent, and interstitial markings are prominent consistent with congestive cardiac failure. 1 Dextrocardia is considered as Degenerative disease Congenital disease Hereditary disease 2 Venous thrombosis most often affect Upper extremity Lower extremity Superficial veins 3 Which of the following is local and temporary impairment of blood circulation Infarction Ischemia Necrosis Thank You