Worldwide, the most frequent cause of death is heart disease. Thus, the common conditions that are evaluated in healthcare facilities are often related to the heart or the cardiovascular system: hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension, atherosclerotic disease, and heart failure Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (ventricular dysfunction), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as myocardial infarction. Total Anomalous Pulmonary Venous Return (TAPVR). In radiologic terms, this region is likely the most frequently studied aspect of human anatomy in healthcare delivery settings. Multiple methods are used, including X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests, CT, MRI, echocardiography Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Tricuspid Valve Atresia (TVA), nuclear imaging Nuclear Imaging Nuclear imaging is the radiologic examination using radiopharmaceuticals, which are radioactive substances taken up by specific types of cells. Nuclear medicine is more concerned with the functional and molecular aspects of the organ or pathology being investigated rather than the structure. Nuclear Imaging, and angiography Angiography Radiography of blood vessels after injection of a contrast medium. Cardiac Surgery. Each test has its advantages and disadvantages and is obtained on the basis of the clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor, acuity of symptoms, and risks and benefits to the patient. It is important to know the roles of imaging studies to help determine the proper treatment.
Last updated: 15 Feb, 2022
Different standard projections:
Chest X-rays can be taken from multiple directions, called “views.” Each view has benefits and drawbacks for different pathologies. The 3 common views are posteroanterior, anteroposterior, and lateral.
Differences between an expiratory and an inspiratory
chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests:
Note that in the inspiratory
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests, the posterior
ribs
Ribs
A set of twelve curved bones which connect to the vertebral column posteriorly, and terminate anteriorly as costal cartilage. Together, they form a protective cage around the internal thoracic organs.
Chest Wall: Anatomy and the pulmonary parenchyma are more easily seen, while in the expiratory
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests, the parenchyma looks hazy and lacks definition.
The following structures must be identified and checked for abnormalities in size or shape:
Posteroanterior
projection
Projection
A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others.
Defense Mechanisms of the chest identifying the mediastinal structures:
PA:
pulmonary artery
Pulmonary artery
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
Lungs: Anatomy
SVC:
superior vena cava
Superior vena cava
The venous trunk which returns blood from the head, neck, upper extremities and chest.
Mediastinum and Great Vessels: Anatomy
Lateral projection Projection A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. Defense Mechanisms of the chest identifying the mediastinal structures
Image by Hetal Verma.Cause | Observation |
---|---|
Rotation Rotation Motion of an object in which either one or more points on a line are fixed. It is also the motion of a particle about a fixed point. X-rays | The shadow of the heart appears bigger in the projection Projection A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. Defense Mechanisms because of the rotation Rotation Motion of an object in which either one or more points on a line are fixed. It is also the motion of a particle about a fixed point. X-rays of the subject to either side. |
Suboptimal inspiration Inspiration Ventilation: Mechanics of Breathing | The diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm: Anatomy moves upward and compresses the heart. |
Portable supine film | Cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) silhouette undergoes magnification because the cassette is placed in contact with the posterior aspect of the patient and the X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests beam penetrates from the anterior aspect. |
Pectus excavatum Pectus Excavatum Cardiovascular Examination | The heart is compressed between the sternum Sternum A long, narrow, and flat bone commonly known as breastbone occurring in the midsection of the anterior thoracic segment or chest region, which stabilizes the rib cage and serves as the point of origin for several muscles that move the arms, head, and neck. Chest Wall: Anatomy and the spine Spine The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum. Vertebral Column: Anatomy. |
Left: Normal index (< 50%)
Right: Cardiac index > 50%, indicative of cardiac enlargement. Image by Hetal Verma.Lateral
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests projections showing a normal heart (left) and an enlarged heart (right):
On the left, note how the anterior and posterior spaces of the heart are preserved, while on the right the posterior aspect of the heart is almost in contact with the thoracic
spine
Spine
The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum.
Vertebral Column: Anatomy.
Differences between anteroposterior (AP) (left) and posteroanterior (PA) (right)
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests projections:
In the AP view, the structures that are farther away from the cassette, such as the heart, are magnified.
Posteroanterior (PA) (left) and lateral (right)
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests projections of the chest showing left ventricular enlargement:
On the PA
projection
Projection
A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others.
Defense Mechanisms, note the enlargement of the left
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) margin (arrow). On the lateral
projection
Projection
A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others.
Defense Mechanisms, note the posterior
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) margin occupying the posterior
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) space (arrow).
Chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests showing right atrial enlargement:
Note the enlargement of the right
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) margin.
Chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests showing left atrial enlargement:
Note the enlargement of the upper portion of the left
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) margin.
Process of obtaining transthoracic echocardiographic imaging: transducer Transducer A device placed on the patient’s body to visualize a target Ultrasound (Sonography) is placed on the chest to obtain views of the heart.
Image: “Heart lpla echocardiography Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Tricuspid Valve Atresia (TVA) diagram” by Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist. License: CC BY 2.5Transesophageal
echocardiogram
Echocardiogram
Transposition of the Great Vessels:
An endoscope is used to guide the
transducer
Transducer
A device placed on the patient’s body to visualize a target
Ultrasound (Sonography) into the
esophagus
Esophagus
The esophagus is a muscular tube-shaped organ of around 25 centimeters in length that connects the pharynx to the stomach. The organ extends from approximately the 6th cervical vertebra to the 11th thoracic vertebra and can be divided grossly into 3 parts: the cervical part, the thoracic part, and the abdominal part.
Esophagus: Anatomy. In most adults, the
probe
Probe
A device placed on the patient’s body to visualize a target
Ultrasound (Sonography) is advanced to the proximal
esophagus
Esophagus
The esophagus is a muscular tube-shaped organ of around 25 centimeters in length that connects the pharynx to the stomach. The organ extends from approximately the 6th cervical vertebra to the 11th thoracic vertebra and can be divided grossly into 3 parts: the cervical part, the thoracic part, and the abdominal part.
Esophagus: Anatomy or midesophagus (or a depth of 28 to 30 cm from the
incisors
Incisors
Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth.
Teeth: Anatomy).
Echocardiogram
Echocardiogram
Transposition of the Great Vessels:
Apical 4-chamber view of the heart
Echocardiogram
Echocardiogram
Transposition of the Great Vessels:
Apical 2-chamber view of the heart
Echocardiogram Echocardiogram Transposition of the Great Vessels showing a left atrial myxoma Myxoma A benign neoplasm derived from connective tissue, consisting chiefly of polyhedral and stellate cells that are loosely embedded in a soft mucoid matrix, thereby resembling primitive mesenchymal tissue. It occurs frequently intramuscularly where it may be mistaken for a sarcoma. It appears also in the jaws and the skin. Cardiac Myxoma
Image: “ Echocardiogram Echocardiogram Transposition of the Great Vessels showing left atrial myxoma Myxoma A benign neoplasm derived from connective tissue, consisting chiefly of polyhedral and stellate cells that are loosely embedded in a soft mucoid matrix, thereby resembling primitive mesenchymal tissue. It occurs frequently intramuscularly where it may be mistaken for a sarcoma. It appears also in the jaws and the skin. Cardiac Myxoma (arrow)” by Al AL Amyloidosis-Said Y, Al AL Amyloidosis-Rached H, Baeesa S, Kurdi K, Zabani I, Hassan A. License: CC BY 3.0
Anatomy of the heart
Anatomy of the heart
The heart is a 4-chambered muscular pump made primarily of cardiac muscle tissue. The heart is divided into 4 chambers: 2 upper chambers for receiving blood from the great vessels, known as the right and left atria, and 2 stronger lower chambers, known as the right and left ventricles, which pump blood throughout the body.
Heart: Anatomy on chest CT
axial
Axial
Computed Tomography (CT) view:
A 4-chamber view of the heart can be obtained with chest CT. The left atrium (LA) can be recognized with 2 pulmonary
veins
Veins
Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia.
Veins: Histology returning blood to it. The left ventricle (LV), with its thicker walls, is seen in continuity with the left atrium. The right atrium (RA) and right ventricle (RV) are more difficult to see in this image. The ascending and
descending aorta
Descending aorta
Mediastinum and Great Vessels: Anatomy (A) are also visible.
An
axial
Axial
Computed Tomography (CT) cut of a chest CT scan visualizing the heart chambers:
Note the thickness of the left ventricular wall. Also, notice the
descending aorta
Descending aorta
Mediastinum and Great Vessels: Anatomy behind the left atrium (LA).
LV: left ventricle
RA: right atrium
Anatomy of the heart
Anatomy of the heart
The heart is a 4-chambered muscular pump made primarily of cardiac muscle tissue. The heart is divided into 4 chambers: 2 upper chambers for receiving blood from the great vessels, known as the right and left atria, and 2 stronger lower chambers, known as the right and left ventricles, which pump blood throughout the body.
Heart: Anatomy on chest CT on
coronal
Coronal
Computed Tomography (CT) view:
Coronal
Coronal
Computed Tomography (CT) view of the heart on chest CT provides more readily recognizable anatomic landmarks, with the
aorta
Aorta
The main trunk of the systemic arteries.
Mediastinum and Great Vessels: Anatomy (A) arising from the left ventricle (LV) and the
superior vena cava
Superior vena cava
The venous trunk which returns blood from the head, neck, upper extremities and chest.
Mediastinum and Great Vessels: Anatomy (SVC) feeding into the right atrium (RA). The left
pulmonary artery
Pulmonary artery
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
Lungs: Anatomy (PA) can be seen head on, but its source (the right ventricle) is hidden in this image.
Aortic CTA CTA A non-invasive method that uses a ct scanner for capturing images of blood vessels and tissues. A contrast material is injected, which helps produce detailed images that aid in diagnosing vascular diseases. Pulmonary Function Tests:
CT pulmonary angiography Angiography Radiography of blood vessels after injection of a contrast medium. Cardiac Surgery ( CTPA CTPA Pulmonary Function Tests):
An
axial
Axial
Computed Tomography (CT) cut of a chest CT scan visualizing the great vessels
A:
aorta
Aorta
The main trunk of the systemic arteries.
Mediastinum and Great Vessels: Anatomy
PA:
pulmonary artery
Pulmonary artery
The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.
Lungs: Anatomy
Cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) MRI images:
A:
Cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) MRI
gradient echo
Gradient Echo
Imaging of the Head and Brain sequence of the normal dimensions and function of the left ventricle
B: T2-weighted short Ď„ inversion recovery sequence
C: Late
gadolinium
Gadolinium
An element of the rare earth family of metals. It has the atomic symbol gd, atomic number 64, and atomic weight 157. 25. Its oxide is used in the control rods of some nuclear reactors.
Magnetic Resonance Imaging (MRI) hyperenhancement sequence
Main coronary
arteries
Arteries
Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles.
Arteries: Histology:
The left main
coronary artery
Coronary Artery
Truncus Arteriosus provides blood supply to the left side of the heart. The two branches are the left anterior descending artery and circumflex artery. The
right coronary artery
Right coronary artery
Heart: Anatomy supplies the right side of the heart.
Normal coronary angiogram:
a: Normal left main
coronary artery
Coronary Artery
Truncus Arteriosus (LM), left anterior descending artery (LAD), circumflex artery (Cx)
b: Normal right main
coronary artery
Coronary Artery
Truncus Arteriosus (RCA)
Chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests showing prominent cardiomegaly Cardiomegaly Enlargement of the heart, usually indicated by a cardiothoracic ratio above 0. 50. Heart enlargement may involve the right, the left, or both heart ventricles or heart atria. Cardiomegaly is a nonspecific symptom seen in patients with chronic systolic heart failure (heart failure) or several forms of cardiomyopathies. Ebstein’s Anomaly and bibasilar interstitial markings in a patient with cardiomyopathy Cardiomyopathy Cardiomyopathy refers to a group of myocardial diseases associated with structural changes of the heart muscles (myocardium) and impaired systolic and/or diastolic function in the absence of other heart disorders (coronary artery disease, hypertension, valvular disease, and congenital heart disease). Cardiomyopathy: Overview and Types
Image: “ Chest x-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests showing moderate cardiomegaly Cardiomegaly Enlargement of the heart, usually indicated by a cardiothoracic ratio above 0. 50. Heart enlargement may involve the right, the left, or both heart ventricles or heart atria. Cardiomegaly is a nonspecific symptom seen in patients with chronic systolic heart failure (heart failure) or several forms of cardiomyopathies. Ebstein’s Anomaly and prominent bibasilar interstitial markings” by Ibebuogu UN, Thornton JW, Reed GL. License: CC BY 2.0Echocardiogram Echocardiogram Transposition of the Great Vessels showing left ventricular dilatation during acute heart failure Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (ventricular dysfunction), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as myocardial infarction. Total Anomalous Pulmonary Venous Return (TAPVR)
Image: “Echocardiograph showing dilatation of the left ventricle in the acute phase Acute phase Short Bowel Syndrome” by Gangadhar TC, Von der Lohe E, Sawada SG, Helft PR. License: CC BY 2.0
Transthoracic echocardiogram
Transthoracic echocardiogram
Endocarditis:
A: Parasternal long-
axis
Axis
The second cervical vertebra.
Vertebral Column: Anatomy view showing asymmetric septal hypertrophic
cardiomyopathy
Cardiomyopathy
Cardiomyopathy refers to a group of myocardial diseases associated with structural changes of the heart muscles (myocardium) and impaired systolic and/or diastolic function in the absence of other heart disorders (coronary artery disease, hypertension, valvular disease, and congenital heart disease).
Cardiomyopathy: Overview and Types in end
diastole
Diastole
Post-systolic relaxation of the heart, especially the heart ventricles.
Cardiac Cycle
B: 4-chamber view showing a combination of basal and midventricular hypertrophic
cardiomyopathy
Cardiomyopathy
Cardiomyopathy refers to a group of myocardial diseases associated with structural changes of the heart muscles (myocardium) and impaired systolic and/or diastolic function in the absence of other heart disorders (coronary artery disease, hypertension, valvular disease, and congenital heart disease).
Cardiomyopathy: Overview and Types and an apical
aneurysm
Aneurysm
An aneurysm is a bulging, weakened area of a blood vessel that causes an abnormal widening of its diameter > 1.5 times the size of the native vessel. Aneurysms occur more often in arteries than in veins and are at risk of dissection and rupture, which can be life-threatening.
Thoracic Aortic Aneurysms (*)
Ao:
aorta
Aorta
The main trunk of the systemic arteries.
Mediastinum and Great Vessels: Anatomy
LA = left atrium
RA = right atrium
RV = right ventricle
Image: “ Transthoracic echocardiogram Transthoracic echocardiogram Endocarditis” by Cianciulli TF, Saccheri MC, Konopka IV, Serans DF, Acunzo RS, Escudero AM, Masoli OH, Prezioso HA HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia. License: CC BY 2.0
Cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) MRI showing a marked hypertrophic
cardiomyopathy
Cardiomyopathy
Cardiomyopathy refers to a group of myocardial diseases associated with structural changes of the heart muscles (myocardium) and impaired systolic and/or diastolic function in the absence of other heart disorders (coronary artery disease, hypertension, valvular disease, and congenital heart disease).
Cardiomyopathy: Overview and Types:
Balanced fast-field
echocardiogram
Echocardiogram
Transposition of the Great Vessels (bFFE) cine sequence, short-
axis
Axis
The second cervical vertebra.
Vertebral Column: Anatomy view (A); 4-chamber view (B); a left ventricular
hypertrophy
Hypertrophy
General increase in bulk of a part or organ due to cell enlargement and accumulation of fluids and secretions, not due to tumor formation, nor to an increase in the number of cells (hyperplasia).
Cellular Adaptation with normal contractility was recognized.
T1-weighted black blood turbo spin echo sequence, short-
axis
Axis
The second cervical vertebra.
Vertebral Column: Anatomy view (C); left ventricular
hypertrophy
Hypertrophy
General increase in bulk of a part or organ due to cell enlargement and accumulation of fluids and secretions, not due to tumor formation, nor to an increase in the number of cells (hyperplasia).
Cellular Adaptation is evident, specifically in the septal region. Corresponding view with transmural late
gadolinium
Gadolinium
An element of the rare earth family of metals. It has the atomic symbol gd, atomic number 64, and atomic weight 157. 25. Its oxide is used in the control rods of some nuclear reactors.
Magnetic Resonance Imaging (MRI) enhancement (arrow) in the lateral wall using a T1-weighted inversion recovery 3D fast
gradient echo
Gradient Echo
Imaging of the Head and Brain sequence (D).
Pulmonary embolism
Pulmonary Embolism
Pulmonary embolism (PE) is a potentially fatal condition that occurs as a result of intraluminal obstruction of the main pulmonary artery or its branches. The causative factors include thrombi, air, amniotic fluid, and fat. In PE, gas exchange is impaired due to the decreased return of deoxygenated blood to the lungs.
Pulmonary Embolism:
Chest CT showing multiple
filling defects
Filling Defects
Imaging of the Intestines of the principal branches (arrows) due to
pulmonary embolism
Pulmonary Embolism
Pulmonary embolism (PE) is a potentially fatal condition that occurs as a result of intraluminal obstruction of the main pulmonary artery or its branches. The causative factors include thrombi, air, amniotic fluid, and fat. In PE, gas exchange is impaired due to the decreased return of deoxygenated blood to the lungs.
Pulmonary Embolism
CT scan of
aortic dissection
Aortic dissection
Aortic dissection occurs due to shearing stress from pulsatile pressure causing a tear in the tunica intima of the aortic wall. This tear allows blood to flow into the media, creating a “false lumen.” Aortic dissection is most commonly caused by uncontrolled hypertension.
Aortic Dissection:
a: Plain
axial
Axial
Computed Tomography (CT) slices demonstrating a
hyperintense
Hyperintense
Magnetic Resonance Imaging (MRI)
crescent
Crescent
Rapidly Progressive Glomerulonephritis on the right margin of the aortic lumen indicating
intramural hematoma
Intramural hematoma
Dissection of the Carotid and Vertebral Arteries (arrow)
b: Contrast-enhanced
axial
Axial
Computed Tomography (CT) slices demonstrating the intimal flap (arrow) that underlies the pathognomonic
double-lumen sign
Double-Lumen Sign
Imaging of the Lungs and Pleura
c: Volume-rendered reconstructed image showing the margins of the Stanford type A
aortic dissection
Aortic dissection
Aortic dissection occurs due to shearing stress from pulsatile pressure causing a tear in the tunica intima of the aortic wall. This tear allows blood to flow into the media, creating a “false lumen.” Aortic dissection is most commonly caused by uncontrolled hypertension.
Aortic Dissection (arrow)
The
right coronary artery
Right coronary artery
Heart: Anatomy and the major thoracic and cervical
arteries
Arteries
Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles.
Arteries: Histology are not involved.
Axial
Axial
Computed Tomography (CT) source image of
CTA
CTA
A non-invasive method that uses a ct scanner for capturing images of blood vessels and tissues. A contrast material is injected, which helps produce detailed images that aid in diagnosing vascular diseases.
Pulmonary Function Tests reveals the flap in the
ascending aorta
Ascending aorta
Mediastinum and Great Vessels: Anatomy compatible with type A Stanford dissection:
Arrows: flap in
ascending aorta
Ascending aorta
Mediastinum and Great Vessels: Anatomy
Asterisks: hemopericardium.
Multiple perfusion defects with different degrees of severity.
The upper images are stress phase and lower images are rest or delayed images. There is moderate
ischemia
Ischemia
A hypoperfusion of the blood through an organ or tissue caused by a pathologic constriction or obstruction of its blood vessels, or an absence of blood circulation.
Ischemic Cell Damage in the midanterolateral and midinferolateral walls.
There also is severe
ischemia
Ischemia
A hypoperfusion of the blood through an organ or tissue caused by a pathologic constriction or obstruction of its blood vessels, or an absence of blood circulation.
Ischemic Cell Damage in the basal inferior wall. Mild
ischemia
Ischemia
A hypoperfusion of the blood through an organ or tissue caused by a pathologic constriction or obstruction of its blood vessels, or an absence of blood circulation.
Ischemic Cell Damage in the apex, apical septal, and basal anterolateral regions are also noted.
Calcified plaques in the anterior descending artery, in addition to others (not shown) in the other coronary
arteries
Arteries
Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles.
Arteries: Histology
CAC score = 285 (Agatston method), consistent with moderate coronary calcification, indicating moderate cardiovascular risk
Coronary angiogram:
Stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) of the left anterior descending artery (arrow)
Image: “Coronary angiogram with a stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) of the LAD (arrow)” by Adeoye AM, Adekunle AN, Adebiyi AA AA Amyloidosis, Mullassari A, Vijayakumar S, Nwafor CE. License: CC BY 2.0
Endocarditis
Endocarditis
Endocarditis is an inflammatory disease involving the inner lining (endometrium) of the heart, most commonly affecting the cardiac valves. Both infectious and noninfectious etiologies lead to vegetations on the valve leaflets. Patients may present with nonspecific symptoms such as fever and fatigue.
Endocarditis:
A transesophageal
echocardiogram
Echocardiogram
Transposition of the Great Vessels shows the left atrium (LA), parts of the
mitral valve
Mitral valve
The valve between the left atrium and left ventricle of the heart.
Heart: Anatomy (MV), the left ventricle (LV), the
ascending aorta
Ascending aorta
Mediastinum and Great Vessels: Anatomy (AO), and a thickened aortic cusp (arrow), the last of which is highly suggestive of
endocarditis
Endocarditis
Endocarditis is an inflammatory disease involving the inner lining (endometrium) of the heart, most commonly affecting the cardiac valves. Both infectious and noninfectious etiologies lead to vegetations on the valve leaflets. Patients may present with nonspecific symptoms such as fever and fatigue.
Endocarditis.
Chest X-ray
Chest X-ray
X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs.
Pulmonary Function Tests showing
pericardial effusion
Pericardial effusion
Fluid accumulation within the pericardium. Serous effusions are associated with pericardial diseases. Hemopericardium is associated with trauma. Lipid-containing effusion (chylopericardium) results from leakage of thoracic duct. Severe cases can lead to cardiac tamponade.
Pericardial Effusion and Cardiac Tamponade:
Note global enlargement of both
cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) margins (water bottle heart).
CT shows
cardiomegaly
Cardiomegaly
Enlargement of the heart, usually indicated by a cardiothoracic ratio above 0. 50. Heart enlargement may involve the right, the left, or both heart ventricles or heart atria. Cardiomegaly is a nonspecific symptom seen in patients with chronic systolic heart failure (heart failure) or several forms of cardiomyopathies.
Ebstein’s Anomaly with large
pericardial effusion
Pericardial effusion
Fluid accumulation within the pericardium. Serous effusions are associated with pericardial diseases. Hemopericardium is associated with trauma. Lipid-containing effusion (chylopericardium) results from leakage of thoracic duct. Severe cases can lead to cardiac tamponade.
Pericardial Effusion and Cardiac Tamponade:
a: Bilateral pleural effusions with left lower lobe nearly completely collapsed
b: Parasternal long-
axis
Axis
The second cervical vertebra.
Vertebral Column: Anatomy
echocardiogram
Echocardiogram
Transposition of the Great Vessels showing
pericardial effusion
Pericardial effusion
Fluid accumulation within the pericardium. Serous effusions are associated with pericardial diseases. Hemopericardium is associated with trauma. Lipid-containing effusion (chylopericardium) results from leakage of thoracic duct. Severe cases can lead to cardiac tamponade.
Pericardial Effusion and Cardiac Tamponade of moderate size with diastolic
compression
Compression
Blunt Chest Trauma of the right atrium (asterisk)
Transthoracic 2-dimensional
echocardiogram
Echocardiogram
Transposition of the Great Vessels:
Note the circumferential
pericardial effusion
Pericardial effusion
Fluid accumulation within the pericardium. Serous effusions are associated with pericardial diseases. Hemopericardium is associated with trauma. Lipid-containing effusion (chylopericardium) results from leakage of thoracic duct. Severe cases can lead to cardiac tamponade.
Pericardial Effusion and Cardiac Tamponade on the long- and short-
axis
Axis
The second cervical vertebra.
Vertebral Column: Anatomy parasternal views on this
transthoracic echocardiogram
Transthoracic echocardiogram
Endocarditis, prior to
pericardiocentesis
Pericardiocentesis
Puncture and aspiration of fluid from the pericardium.
Cardiac Surgery.
LV: left ventricle
PE:
pericardial effusion
Pericardial effusion
Fluid accumulation within the pericardium. Serous effusions are associated with pericardial diseases. Hemopericardium is associated with trauma. Lipid-containing effusion (chylopericardium) results from leakage of thoracic duct. Severe cases can lead to cardiac tamponade.
Pericardial Effusion and Cardiac Tamponade