What is a significant disadvantage of cardiac CT compared to chest X-ray?
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More radiation exposure.
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What is a significant disadvantage of cardiac CT compared to chest X-ray?
More radiation exposure.
Why is no sedation required for cardiac CT scans?
Because of the quick image acquisition time (3-5 seconds).
Where do the small cardiac veins and the oblique vein of the left atrium (Vein of Marshall) terminate?
They empty into the right atrium.
What does a normal PA and lateral chest view show?
A normal PA and lateral chest view shows the standard anatomical structures of the chest without any abnormalities.
What are the contraindications for cardiac MRI?
Presence of metallic fragments and pacemakers.
What is dextrocardia associated with?
Mirror image positioning of the great vessels and arch of the aorta; apex is misplaced to the right instead of the left.
What is the primary use of chest X-rays in cardiovascular assessment?
Chest X-rays are used primarily for initial screening.
What are the signs of left atrial enlargement (LAE) on an X-ray?
Signs include cardinal widening to greater than 90 degrees (black arrow), elevation of left main branches, and enlargement of the left atrial appendage (black arrowhead).
Describe the flow of oxygenated blood through the heart.
Pulmonary veins → Left Atrium → Mitral Valve → Left Ventricle → Aortic Valve → Aorta → Body
What is the normal C:T ratio in newborns?
Approximately 0.65.
What is the normal Cardiac Thoracic (CT) Ratio in newborns?
Approximately 0.65
Describe the flow of deoxygenated blood through the heart.
Superior Vena Cava & Inferior Vena Cava → Right Atrium → Tricuspid Valve → Right Ventricle → Pulmonary Valve → Pulmonary Trunk → Pulmonary Arteries → Lungs.
What abnormalities can be detected in a chest X-ray related to the heart?
Cardiomegaly and the presence of a bipolar pacemaker.
What is the most common cause of Coronary Heart Disease?
Diabetes.
Which veins open directly into the right atrium?
The anterior cardiac vein and the venae cordis minimae.
What are the semilunar valves of the heart?
Pulmonary (PV) and Aortic Valves (AV).
What components form the right cardiac border on a chest X-ray?
The right atrium, superior vena cava, and inferior vena cava.
Where can the moderator band be seen in the heart?
In the right ventricle.
What components form the right cardiac border?
Right Atrium, Superior Vena Cava, Inferior Vena Cava
What are the four chambers of the heart?
Right Atrium (RA), Right Ventricle (RV), Left Atrium (LA), Left Ventricle (LV).
What does the presence of dye in the left chambers of the heart indicate in imaging?
It lightens the appearance of the left chambers.
What are the terminal branches of the Left Coronary Artery (LCA)?
Left anterior descending (LAD) and left circumflex (Cx) arteries.
What does Figure 26 show?
Coronary vessels with severe blockage in the left anterior descending coronary artery (left), and post-stent placement (right).
What is the primary function of the coronary sinus?
It drains most of the venous blood from the heart.
What are the advantages of cardiac MRI?
High soft tissue contrast, large field of view, no ionizing radiation, and safe for pregnant patients.
What is the significance of the cardiac thoracic ratio (C:T ratio)?
The C:T ratio is used to estimate the size of the heart and can indicate cardiac enlargement.
What does a bipolar pacemaker look like on an X-ray?
A bipolar pacemaker is indicated by a green arrow pointing to the right atrium and a red arrow pointing to the right ventricle.
What is the normal C:T ratio in adults?
Usually 0.5 or less.
What does the yellow arrow indicate in Figure 22?
A soft tissue lesion at the Right Atrium.
What are the indications for Cardiac CT/Coronary CT Angiography?
Coronary Artery Disease, Congenital Coronary Artery Anomalies, Post-operative assessment of bypass grafts (stents), Visualization of cardiac veins, Soft tissue lesions
What vessels carry deoxygenated blood to the heart?
Superior Vena Cava (SVC) and Inferior Vena Cava (IVC).
What does Figure 25 illustrate?
Good coronary vessel visualization: normal heart artery (no plaque) and coronary vessel with a fatty plaque.
Where is the opening of the coronary sinus located in relation to the IVC opening?
Inferior and left of the IVC opening.
What is cardiomegaly?
Cardiomegaly is an enlarged heart.
What are the indicators of right ventricular enlargement on an X-ray?
Indicators include a small aortic knob (blue arrow), a prominent pulmonary trunk (red arrow), and a dilated pulmonary trunk and artery (black arrow).
List some indications for cardiac MRI.
Myocardial disease, congenital cardiac anomalies, acquired heart disease, cardiac mass, myocardial ischemia or infarction, cardiomyopathies, and pericardial diseases.
What conditions can cardiac CT scans help diagnose?
Coronary Artery Disease (CAD), congenital coronary artery anomalies, post-operative assessment of bypass grafts, visualization of cardiac veins, and soft tissue lesions.
What is the normal Cardiac Thoracic (CT) Ratio in adults?
Usually 0.5 or less
What is the origin of the Right Coronary Artery (RCA)?
From the anterior aortic sinus.
What are the advantages of a Cardiac CT scan over other imaging modalities?
More detailed examination compared to chest X-ray, Less artifact than Cardiac MRI, Capable of visualizing the heart's anatomy, vessels, and soft tissues in fine detail
What are the abbreviations for the four main heart valves?
AV (Aortic Valve), TV (Tricuspid Valve), MV (Mitral Valve), PV (Pulmonary Valve).
Name the four chambers of the heart.
Right Atrium (RA), Right Ventricle (RV), Left Atrium (LA), Left Ventricle (LV).
What components form the left cardiac border on a chest X-ray?
The aorta, pulmonary artery, and left ventricle.
What can border abnormalities in a chest X-ray indicate?
Possible cardiac pathology
What are the differences between a chest X-ray and a cardiac CT scan in terms of imaging depth?
Chest X-ray provides a flat 2D image with no depth, while cardiac CT scan provides hundreds of slices in 3D with depth.
From where do the coronary arteries arise?
From the ascending aorta immediately above the aortic valve.
Describe the flow of oxygenated blood through the heart.
Pulmonary veins → Left Atrium → Mitral Valve → Left Ventricle → Aortic Valve → Aorta → Body.
What branches does the Circumflex (Cx) artery give rise to?
Marginal branches (M1, M2).
What imaging modality is inferior to CT scan when evaluating coronary arteries?
Cardiac MRI.
What does an abnormal cardiac border on a chest X-ray indicate?
It could indicate pathology such as chamber enlargement, generalized heart enlargement, pericardial effusion, or a tumor.
What does left ventricular enlargement look like on an X-ray?
Left ventricular enlargement shows an enlarged left ventricle compared to a normal heart.
Name the different views used in cardiac MRI.
2-Chamber View, 3-Chamber View, 4-Chamber View, Short-Axis View.
What components form the left cardiac border?
Aorta, Pulmonary Artery, Left Ventricle
Name the atrioventricular valves of the heart.
Tricuspid Valve (TV) and Mitral Valve (MV).
Where does the Right Coronary Artery (RCA) run?
Along the right AV groove.
What are the terminal branches of the Right Coronary Artery (RCA)?
Posterior descending artery (PDA).
What are the abbreviations for the four heart chambers?
RA (Right Atrium), RV (Right Ventricle), LA (Left Atrium), LV (Left Ventricle).
Which valve is most commonly assessed in a CT scan?
The aortic valve.
What are the tributaries of the coronary sinus?
Great cardiac veins and middle cardiac veins.
Where is the cardiac apex located?
Formed by the inferolateral part of the left ventricle, lies posterior to the left 5th intercostal space in adults, usually approximately 9 cm from the median plane.
What are the atrioventricular valves of the heart?
Tricuspid (TV) and Mitral (Bicuspid; MV) Valves.
What type of blood do the Superior and Inferior Vena Cava carry?
Deoxygenated/Oxygen-poor blood from the systemic circuit.
Describe the flow of deoxygenated blood through the heart.
Atrium → Tricuspid Valve → Right Ventricle → Pulmonary Valve → Pulmonary Trunk → Pulmonary Arteries → Lungs
What are the indications for a chest X-ray in cardiovascular assessment?
Chamber enlargement, generalized heart enlargement, pericardial effusion, tumor
Which chamber of the heart is the most anterior?
Right Ventricle.
What are the semilunar valves in the heart?
Pulmonary Valve (PV) and Aortic Valve (AV).
Where does the Left Coronary Artery (LCA) run?
Along the left AV groove.
What imaging modality provides different views of the heart?
Cardiac MRI.
What is the significance of the venae cordis minimae?
They are small veins that drain directly into the heart chambers.
What does right atrial enlargement indicate?
Right atrial enlargement is a specific type of chamber enlargement affecting the right atrium, which forms the right cardiac border.
What are the advantages of a cardiac CT scan over a chest X-ray?
More detailed examination, capable of visualizing the heart's anatomy, vessels, and soft tissues in fine detail, and provides depth.
What is the significance of the cardiac valves in imaging?
Cardiac valves are crucial for understanding the flow of blood through the heart and identifying any valvular abnormalities.
What is the significance of the heart starting to beat around 21-23 days after conception?
It establishes blood circulation even before the heart becomes fully developed with four chambers.
Which chamber of the heart is the most posterior?
Left Atrium.
What is the origin of the Left Coronary Artery (LCA)?
From the left posterior aortic sinus.
What branches does the Left Anterior Descending (LAD) artery give rise to?
Diagonal branches (D1, D2) and septal branches.
What is the most common cause of blockage or narrowing in coronary vessels?
Calcification.
What is the origin of the coronary sinus?
It is a direct continuation of the great cardiac vein.
How do you assess where the right/left side is in a Chest X-ray?
Look at the LABEL, NOT the heart.
List the major vessels associated with the heart.
Superior Vena Cava (SVC), Inferior Vena Cava (IVC), Pulmonary Artery (PA), Pulmonary Veins (PV), Aorta.
How long does the acquisition of a cardiac MRI typically take?
45 minutes to 1 hour.
What is dextrocardia?
Dextrocardia is a condition where the heart is positioned on the right side of the chest instead of its normal position on the left.
Why should the label on the X-ray be used as a guide?
To avoid confusion or misdiagnosing dextrocardia.
Describe the process of measuring the cardiac thoracic ratio (C:T ratio).
The C:T ratio is measured by relating the widest diameter of the heart (A + B) to the widest internal diameter of the chest (C).
What are the advantages of a chest X-ray over other imaging modalities?
Minimal radiation, 1 sec acquisition, Low cost, Flat image (2D), No contrast media
What are the main components assessed in a cardiac CT or coronary CT angiography?
Borders of the heart, chambers of the heart, arterial supply (coronary arteries), valves, and venous drainage.
Which three major vessels are affected in Coronary Artery Disease (CAD)?
Left Anterior Descending (LAD), Left Circumflex artery (Cx), and Right Coronary artery (RCA).
What percentage of persons have dextrocardia?
Dextrocardia occurs in about 1 in 12,000 pregnancies.
What should be done if cardiomegaly is suspected on an X-ray?
Further imaging should be requested.
What is the most common dedicated cardiac CT examination?
Coronary CT Angiography.
What structures are visible in the lateral view of a chest X-ray?
Right ventricle, left atrium, left ventricle, and left & right domes of the diaphragm.
At what age do patients typically present with Coronary Artery Disease (CAD)?
70 years old and above.
Why might pregnant women avoid X-rays?
Due to minimal radiation exposure, but it depends if the advantage outweighs the disadvantage.
What are the indications for Cardiac MRI?
Myocardial disease, Congenital cardiac anomalies, Acquired heart disease, Cardiac mass, Myocardial ischemia or infarction, Cardiomyopathies, Pericardial diseases
What are the advantages of a Cardiac MRI over other imaging modalities?
No radiation, High soft tissue contrast, Capable of visualizing cardiac mass and myocardial disease
What is the significance of the cardiac thoracic ratio in a chest X-ray?
It helps assess the size of the heart relative to the chest cavity.
What does the presence of calcification and fatty plaque in coronary vessels cause?
Stenosis or narrowing, inhibiting blood flow.
What is the radiation exposure during a chest X-ray equivalent to?
Sunbathing on the beach for half of the day.
What can be assessed using the axial view of the ventricles/atrium in cardiac imaging?
The cause of the enlargement of the heart walls.
What is indicated by a soft tissue density/tumor (myxoma) in the left atrium?
The presence of a tumor in the left atrium.
Which vessels carry oxygenated blood from the lungs to the heart?
Pulmonary veins.
What is the significance of Figure 24?
It shows a reconstructed image of the smooth angiography of coronary vessels.
