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Congenital Heart Diseases

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A power point presentation about common cardiac anomalies with diagrammatic illustrations.

Published in: Health & Medicine
  • nice with good illustration of named signs, can you please let me get the copy by mail to naveenjust@yahoo.co.in
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Congenital Heart Diseases

  1. 1. CLASSIC IMAGING SIGNS OF CONGENITAL CARDIOVASCULAR ABNORMALITIES<br />MOHAMMA D AMIR<br />JJM MEDICAL COLLEGE<br />DAVANGERE<br />INDIA<br />1<br />
  2. 2. Figure 1. Transposition of the great arteries compared with normal anatomy. (a) Chest radiograph obtained<br />in a neonate shows narrowing of the superior mediastinum, enlargement of the cardiac silhouette with abnormal<br />convexity of the right atrial border, and increased vascular flow—typical features of transposition of the<br />great arteries. (b) Same image as a with a superimposed drawing shows the characteristic cardiomediastinal<br />silhouette: the egg-on-a-string sign. (c) Chest radiograph obtained in another neonate shows the normal appearance<br />of the mediastinum, with a normal thymic shadow. (d) Drawing shows the pattern of blood flow (arrows)<br />through the heart with transposition of the great arteries. The aorta (1) arises from the right ventricle (2),<br />and the pulmonary artery (3) arises from the left ventricle (4). Communication between the systemic and the<br />pulmonary circulation—an interatrial septal defect (5), an interventricular septal defect (6), or both—sustains<br />life by allowing oxygenated blood from the left atrium (7) to mix with deoxygenated blood from the right<br />atrium (8) before it flows via the right ventricle to the aorta and via the left ventricle to the pulmonary artery.<br />2<br />
  3. 3. 3<br />
  4. 4. Figure 2. Type I TAPVR. (a, b) Chest radiograph obtained in a neonate (b the same as a<br />with a superimposed drawing) reveals the classic snowman sign, sometimes referred to as a<br />figure-of-eight sign. (c) Drawing shows the return flow of venous blood (arrows). Instead of<br />draining into the left atrium (1), the pulmonary veins (2, 3) converge behind the heart to<br />form a common pulmonary vein (4) that connects to the vertical vein (5), which joins the<br />left innominate vein (6). The left innominate vein drains into the superior vena cava (7).<br />Since all of the systemic and pulmonary venous blood enters the right heart, survival is maintained<br />by a right-to-left shunt through a communication at the level of the atrial septum (8).<br />9 right atrium, 10 right ventricle, 11 left ventricle. (d) Frontal view obtained with<br />angiocardiography in a neonate shows the aberrant cardiovascular anatomy: The upper left<br />heart is bordered by the vertical vein; the superior part of the heart, by the left innominate<br />vein; and the upper part of the right heart, by the dilated superior vena cava<br />4<br />
  5. 5. 5<br />
  6. 6. Figure 3. Partial anomalous pulmonary venous return.<br />(a, b) Chest radiograph obtained in a patient with a heart murmur<br />(b the same as a with a superimposed drawing) demonstrates<br />a prominent curvilinear opacity that extends downward<br />from the right hilum: the scimitar sign. (c) Drawing shows<br />the pattern of blood flow (arrows). The luminal diameter<br />of the scimitar vein (1), which may drain all or part of the<br />right lung (2), enlarges as the vein descends below the diaphragm<br />(3) to empty into the inferior vena cava (4). Occasionally,<br />the vein may empty directly into the right atrium (5)<br />6<br />
  7. 7. Figure 4. Endocardial cushion defect. (a, b) Lateral view obtained<br />with angiocardiography (b the same as a with a superimposed<br />drawing) shows shortening of the left ventricular inflow<br />tract and elongation and narrowing of the left ventricular outflow<br />tract, which together produce the characteristic gooseneck<br />sign. (c) Drawing (anteroposterior view) of an endocardial cushion<br />defect shows the concavity of the medial margin of the left<br />ventricle (1) below the mitral valve and resultant narrowing of<br />the left ventricular outflow tract (2).<br />7<br />
  8. 8. Figure 5. Tetralogy of Fallot. (a, b) Chest radiograph obtained in<br />an infant with a right-sided aortic arch (b the same as a with a superimposed<br />drawing) shows the characteristic boot-shaped sign produced<br />by upturning of the cardiac apex because of right ventricular hypertrophy<br />and by the concavity of the main pulmonary artery. (c) Drawing<br />depicts the pattern of blood flow (arrows) with the characteristic ventricular<br />septal defect (1), infundibular pulmonary stenosis (2), overriding<br />aorta (3), and right ventricular hypertrophy (4). The oxygen-rich<br />blood in the left side of the heart (5) mixes with oxygen-poor blood in<br />the right side of the heart (6) before it proceeds to the aorta (7).<br />8<br />
  9. 9. Figure 6. Aortic coarctation with associated rib notching. (a, b) Frontal view (a) and close-up frontal view (b) obtained<br />with chest radiography in a young man with hypertension show the figure-of-three sign formed by prestenotic<br />and poststenotic dilatation of the aorta, with an intervening indentation at the site of coarctation and with bilateral rib<br />notching caused by pressure from intercostal blood vessels. (c, d) Chest radiograph in a child (d the same as c with a<br />superimposed 3) shows clear rib notching despite less pronounced coarctation. (e, f ) Left anterior oblique view of<br />the chest, obtained with barium esophagography (b the same as a with a superimposed reversed 3), shows an indentation<br />in the esophageal contour because of pressure from the coarctated aorta.<br />9<br />
  10. 10. 10<br />
  11. 11. Figure 7. Localized (postductal or adulttype)<br />aortic coarctation. Drawing shows a focal<br />constriction of the aorta (1) just beyond<br />the origin of the left subclavian artery (2) and<br />the ligamentum arteriosum (3). The contour<br />of the aorta is deformed by both pre- and<br />poststenotic dilatation, and the left subclavian<br />artery is dilated. 4 left common carotid artery,<br />5 innominate artery, 6 right heart<br />structures, 7 left heart structures, 8 pulmonary<br />artery.<br />11<br />
  12. 12. Figure 8. Tubular hypoplasia (preductal or<br />infantile-type aortic coarctation). Drawing<br />shows a focal constriction of the aorta (1)<br />above the level of the ductus arteriosus (2)<br />and a lengthy narrowed segment of the aortic<br />arch (3) after the origin of the innominate<br />artery (4). 5 left common carotid artery,<br />6 left subclavian artery, 7 right heart<br />structures, 8 left heart structures, 9 pulmonary<br />artery<br />12<br />
  13. 13. Figure 9. Ebstein anomaly. (a, b) Frontal (a) and lateral (b) views obtained with chest radiography in<br />an infant show massive cardiomegaly with decreased pulmonary flow. (c) Frontal view (same as a with a<br />superimposed drawing) best depicts the box-shaped heart, an appearance caused by enlargement of the<br />right atrium and hypoplasia of the pulmonary trunk. (d) Drawing shows the pattern of blood flow (arrows)<br />caused by downward displacement of the tricuspid valve (1), with resultant formation of a common<br />chamber (3) consisting of the right ventricle (2) and the dilated right atrium (4), and by the rightto-<br />left shunt of blood through a defect at the atrial level (5). 6 left atrium, 7 left ventricle, 8 aorta,<br />9 pulmonary artery.<br />13<br />
  14. 14. 14<br />

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