radiology.Lect 3 CVS.(dr.abeer)

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radiology.Lect 3 CVS.(dr.abeer)

  1. 1. Pulmonary Arterial Hypertension: The pressure in the pulmonary artery depends on *.Cardiac output -1.Pulmonary vascular resistance -2
  2. 2. Pulmonary Arterial HypertensionConditions that cause significant pulmonary arterial *hypertension all increase the resistance of blood flow: through the lungs, examples.(Various lung diseases (cor pulmonale -1.Pulmonary embolism -2 Pulmonary arterial narrowing in response to -3mitral.valve diseases orLt. to Rt. shunt .Idiopathic pulmonary hypertension -4
  3. 3. Pulmonary Arterial Hypertension: By CXR * There will be enlargement of the mean pulmonary artery + the hilar pulmonary artery, vessels within the lung tissue .are normal or small: Eisenmengers syndrome * Greatly raised pulmonary artery resistance in association withASD ,VSD , &PDA leading toreverse shunt (i.e. :Rt. to .(Lt. shunt
  4. 4. Pulmonary Arterial HypertensionThe cause of pulmonary arterial hypertension may be *visible on the CXR as cor pulmonale & mitral valve .diseases Pulmonary Arterial Hypertension due to ASD & Eisenmengers syndrome
  5. 5. Pulmonary Venous HypertensionThe commonest causes of pulmonary venous hypertension *: are.Mitral valve diseases -1.Lt. ventricular failure -2normal upright person )by CXR ( thelower zone vessels In *arelarger than theupper. zoneupper zone vessels In pulmonary venous hypertension the *. areenlargedsevere cases , theupper zone vessels becomelarger In * than that of thelower zone, & eventually Pulmonary Edema .will supervene & may obscure the blood vessels
  6. 6. Pulmonary Venous Hypertension Pulmonary Venous Hypertension in a patient with Mitral Valve Disease
  7. 7. AortaWith aging the aorta becomes elongated, elongation * necessarily involveunfolding , where theascending aorta, will deviate to theRt. & thedescending aorta to the.Ltbecause the aorta is fixed at theaortic valve & the.diaphragm.confused withaortic dilatation Unfolding aorta is easily *: Aortic dilatation of the ascending aorta is due to *.Aneurysm -1.Aortic regurgitation or aortic stenosis -2.Systemic hypertension -3The two common causes of descending aortic aneurysm *: are.Atheroma -1Aortic dissection. (Also, there is a rare cause as -2.(previous trauma following decelerating injury
  8. 8. Aorta: By CXR * The diagnosis of aortic aneurysm may be obvious, but -1 substantial dilatation may be needed before the bulge of .Rt. mediastinal border can be recognized Atheromatous aneurysm invariably shows calcification of -2 .their walls : NoteCT scan with IVCM orCT angiography orMRA are very *.useful to assess the aneurysm IVCM =I.V. C ontrastM.edia MRA =M agnaticR esonanceA.ngiography
  9. 9. Dissecting Aortic Aneurysm It is important to know the extent of the dissecting aneurysm as those involving the ascending aorta are treated surgically & those confined to the descending .aorta are treated with hypotensive drugs: By CXR * : Two congenital aortic anomalies can be seen, & they are .Coarctation of Aorta -1 ,Rt. sided aortic arch, in association with TOF -2 Pulmonary Atresia, & Truncus Arteriosus, or it also .can be isolated with no clinical significance
  10. 10. Dissecting Aortic Aneurysm Trans-Esophageal Echocardiogram showing the True (T( & False (F( lumina in the descending aorta
  11. 11. Dissecting Aortic Aneurysm CT-scan showing the displaced intima (arrows( separating the true & false luminae in the ascending & descending aorta

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