DDX Cardiovascular

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Situs and Cardiac Malpositions Situs Solitas: Normal all structures are concordant
Situs and Cardiac Malpositions Situs Solitas with Dextrocardia: Cardiac Apex on the Right with stomach bubble on the Left
caused by failure of rotation of the embryonic cardiac loop

Scimitar Syndrome is dextrocardia, hypoplastic right lung
and partial anomalous pulmonary venous drainage into the vena cava
Situs and Cardiac Malpositions Levoconversion with Abdominal situs Inversus: incidence with congenital heart disease 100%
Situs and Cardiac Malpositions Situs Ambiguus with bilateral right sidedness ASPLENIA SYNDROME: absent spleen, bilateral trilobed lung, right and left lobes of the liver are of similar size
Situs and Cardiac Malpositions Situs Ambiguus with bilateral left sidedness POLYSPLENIA SYNDROME: bilateral bilobed lungs, absent hepatic segment of IVC and enlarged azygous, hemiazygous veins. Intracardiac anomalies
Gross Cardiac Enlargement: Multiple Valvular Disease
Pericardial Effusion
ASD (with pulmonary plethora of Eisenmenger)
Cardiomyopathy
Ebsteins Anomaly (posterior orseptal cusp of the tricuspid valve arises distally from the wall of the right ventricle. Marked tricuspid incompetence. Marked right atrioventricular enlargement. Small aorta, oligeamic lungs, sharp cardia outline
Small Heart: Normal Variant
Emphysema
Addison's Disease
Dehydration/Malnutrition
Constrictive Pericarditis
Enlarged Right Atrium Volume Overload Pa prominent right heart border lateral prominent anterosuperior part of the cardiac shadow: ASD
AV canal
Tricuspid incompetence
anomalous pulmonary venous drainage
Enlarged Right Atrium Pressure Overload: Tricuspid Stenosis (NB tricuspid atrsia a shunt must excist atrial size is preserved)
Myxoma of the Right atrium
Enlarged Right Atrium Secondary to right ventricular failure: See question for answer
Enlarged Right Ventricle PA prominent left haert border Lateral Prominent anterior part of the cardiac shadow Secondary to Left heart failure/mitral valve disease: See question
Enlarged Right Ventricle Pulmonary artery Hypertension: Diffuse lung disease
Pulmonary embolism
chronic left to right shunt
vasculitis (polyarteritis nodosa)
Idiopathic
Enlarged Right Ventricle Pressure Overload: Pulmonary stenosis
Enlarged Right Ventricle Volume Overload: ASD
VSD
Enlarged Left Atrium Pa Prominentleft atrial appendage Double right heart border Increased density due to left atrium Splaying of the Carina and Elevated Left haert border Lateral Prominent posterior part of the cardi: Mitral Incompetence
VSD
PDA
ASD (with shunt reversal Eisenmenger or Tricuspid atresia)
Enlarged Left Atrium Pressure Overload: Mitral Stenosis
Myxoma of the Left Atrium
Enlarged Left Atrium Secodary to Left Ventricular failue: See Question
Enlarged Left Ventricle PA Prominent left heart border Rounding of the left heart border Apex displaced inferiorly Lateral Prominent posteroinferior part of the cardiac shadow: MYOCARDIAL
Ischemia
Cardiomyopathy/myocarditis

VOLUME OVERLOAD
Aortic Incompetence
Mitral Incompetence
VSD
PDA

HIGH OUTPUT STATE
Anemia
HPT
Paget's
AV fistula

PRESSURE OVERLOAD (Dilation is end stage)
Aortic Stenosis
Hypertension
Coarctation of the Aorta
Bulge on the Left Heart Border: Enlarged left atrial appendage
ventricular aneurysm
pericardial cyst
Myocardial mass (neoplasm, hytatid
Coronary Artery Aneurysm
Cardiac Calcification: PERICARDIAL
Post pericarditis
Post traumatic/operative
Uraemia
Asbestos
Coronary Artery

MYOCARDIAL
Calcified infarct
Aneurysm
Post myocarditis (Rheumatic Fever)
Hydatid

INTRACARDIAC
Calcified Valve
Calcified Thrombus
Atrial Myxoma
Valve Calcification: AORTIC VALVE
Bicuspid aortic valve
Rheumatic heart disaese
Ageing
Syphilis
Ank Spon

MITRAL VALVE
Rheumatic Heart Disease

PULMONARY VALVE
Valve Stenosis
Tetralogy
Pulmonary Hypertension

TRICUSPID VALVE
Pulmonary Valve Stenosis
ASD
Isolated tricuspid regurgitation
Large Aortic Arch: Unfolded aorta
Hypertension
Aortic Incompetence
Aortic Stenosis
Aneurysm
PDA
Small Aortic Arch: Decreased cardiac output
Intracardiac left to right shunt
Coarctation (infantile type)
Trasposition (rotated but not small
Right Sided Aortic Arch Three Types: MIRROR IMAGE BRANCHING 98% incidence of congenital heart disease)
Dextrocardia with situs inversus
Tetralogy
Pulmonary Atresia with VSD

Type II (rare)

Type III
RIGHT SIDED AORTIC ARCH WITH ABERRANT LEFT SUBCLAVIAN ARTERY
Tetralogy 70%
VSD 20%
Coarctation 10%
Enlarged Superior Vena Cava: VOLUME OVERLOAD
Tricuspid Incompetence
TAPVD

OBSTRUCTION
Ca Bronchus
Mediastinal Mass
Mediastinal Fibrosis
Constrictive Pericarditis
Enlarged Azygous Vein: Haert Failure
Portal Hypertension
SVA or IVC obstruction
Pregnancy
Constrictive Pericarditis

DDX
Sinus Venosus Defect right upper middle lobe pulmonary veins drain into SVC
Enlarged Pulmonary Arteries: VOLUME OVERLOAD (enlarged central and peripheral vessels)

L-R shunt
Hyperdynamic circulation (thyrotoxicosis etc)

PERIPHERAL ARTERIAL VASOCONSTRICTION (enlarged central vessels)
Hypoxia
Secondary to pulmonary venous hypertension
Seconadry to L-R shunts

PERIPHERAL ARTERIAL OBLITERATION (enlarged central vessels)
Secondary to L-R shunts
Thromboemboloc Disease PE/Tumor
Schistosomiasis
Vasculitis
Idiopathic pulnmonary hypertension
Enlarge Pulmonary Veins: Left Ventricular Failure
Obsrtruction at mital or atrial level
mitral stenosis
left artrial myxoma
Balll valve thrombus

Obstruction Proximal to the Atrium
TAPVD
Constrictive pericarditis
Mediastinal Fibrosis
Neonatal Pulmonary Venouus Congestion 1st Week Prominent interstitial amrkings indistict vessels perihilar haze pleural effusions cardiomegaly: Overhydration
Aspyxia
hypoplastic left heart
critical aortic stenosis
TAPVD 9obstructe)
Neonatal Pulmonary Venouus Congestion 2nd and 3rd Week: coarctation of the aorta
interrupted aortic arch
Neonatal Pulmonary Venouus Congestion 4th-6th Week: coarctation
critical aortic stenosis
Neonatal Cyanosis With Venous plethora: TGA
Truncus Arteriosis
TAPVD
Single Ventricle
Neonatal Cyanosis With Oligemia and cardiomegaly: Pulmonary stenosis
Ebstein's anomaly
Tricuspid Atresia
Neonatal Cyanosis With Oligemia but no cardiomegaly: Tetralogy
Pulmonary atrsia with vsd
tricuspid atresia

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Deck Info

Number of cards 34