Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 1 Radiographic Pathology for Technologists, 5 th Edition Chapter 8 Cardiovascular System
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Anatomy and Physiology Consists of: Heart Arteries Capillaries Veins Pulmonary circulation Systemic circulation
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 3 Anatomy and Physiology Heart Location Atria Ventricles Layers Endocardium Myocardium Epicardium Blood travel Gas exchange
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 4 Anatomy and Physiology Cardiac cycle Systole Diastole SA node
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 5 Anatomy and Physiology Electrocardiography P wave PR interval QRS complex T wave QT duration
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 6 Anatomy and Physiology Circulatory vessels Arteries Adventitia Adventitia Media Media Intima and lumen Intima and lumen Veins Capillaries
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 7 Imaging Considerations Chest radiography Heart size Cardiomegaly Great vessels Vascular lung markings Pneumothorax Pulmonary emphysema Bony thorax Scoliosis Pectus excavatum
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 8 Imaging Considerations Chest radiography Technical factors Patient positioning Patient positioning Technical factors Technical factors Geometric factors Geometric factors Patient factors Patient factors Image critique Image critique One of most commonly performed radiographic procedures
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 9 Imaging Considerations & Anatomy
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 10 Imaging Considerations Echocardiography M-mode echocardiography 2-D echocardiography Real-time imaging Real-time imaging Transesophageal echocardiography (TEE) Transesophageal echocardiography (TEE) Spectral Doppler Color Doppler Carotid stenosis, DVT Carotid stenosis, DVT Stress echocardiography
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 11 Imaging Considerations
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 12 Imaging Considerations Nuclear cardiology Used to diagnose CAD, congenital heart disease, and cardiomyopathy Myocardial perfusion scan Most widely used procedure Most widely used procedure Gated cardiac blood pool scans Used to evaluate ventricles Used to evaluate ventricles Positron emission tomography (PET)
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 13 Imaging Considerations
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 14 Imaging Considerations Computed tomography (CT) Cardiac scoring EBCT Spiral CT CT angiography (CTA)
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 15 Imaging Considerations
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 16 Imaging Considerations Magnetic resonance imaging (MRI) Recently gained in popularity for use in cardiac studies Uses cine loop May be ECG gated Magnetic resonance angiography (MRA)
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 17 Imaging Considerations
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 18 Imaging Considerations Angiography Most commonly performed procedure for cardiovascular disease Diagnostic vs therapeutic
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 19 Imaging Considerations Therapeutic angiography Percutaneous transluminal coronary angioplasty (PTCA) Stent Thrombolysis Embolization Transjugular intrahepatic portosystemic stent (TIPSS) Percutaneous transluminal angioplasty Permanent catheterization
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 20 Imaging Considerations
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 21 Congenital and Hereditary Diseases Fetal circulatory system Foramen ovale Foramen ovale Ductus arteriosus Ductus arteriosus Incidence of congenital cardiovascular anomalies Etiology Genetic disorders Genetic disorders Chromosomal aberrations Chromosomal aberrations Environmental factors Environmental factors Associated complications Murmur Murmur
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 22 Congenital and Hereditary Diseases Patent ductus arteriosus Incidence Diagnosis Echocardiography Echocardiography Treatment Prognosis
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 23 Congenital and Hereditary Diseases
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 24 Congenital and Hereditary Diseases Coarctation of the aorta Incidence Diagnosis Radiographic appearance Treatment
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 25 Congenital and Hereditary Diseases
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 26 Congenital and Hereditary Diseases Septal defects Atrial septal defect Ventricular septal defect Cause Incidence Diagnosis Radiographic appearance Associated complications Treatment
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 27 Congenital and Hereditary Diseases
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 28 Congenital and Hereditary Diseases Transposition of the great vessels Incidence Diagnosis Radiographic appearance Treatment Prognosis
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 29 Congenital and Hereditary Diseases
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 30 Congenital and Hereditary Diseases Tetralogy of Fallot Combination of four defects Diagnosis Radiographic appearance Treatment
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 31 Valvular Diseases Symptoms Associated clinical findings Diagnosis Noninvasive Invasive Cause of chronic valve disease Rheumatic fever
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 32 Valvular Diseases Valvular stenosis Cause Mitral valve prolapse Incidence Diagnosis Radiographic appearance Prophylaxis Treatment
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 33 Valvular Diseases
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 34 Congestive Heart Failure Occurrence Treatment Left-sided CHF Causes Symptoms Radiographic appearance Right-sided CHF Causes Symptoms Radiographic appearance
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 35 Congestive Heart Failure
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 36 Cor Pulmonale Cause Acute Pulmonary embolism Chronic COPD Symptoms Diagnosis Radiographic appearance Treatment
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 37 Degenerative Diseases Atherosclerosis Most prevalent disease in humans Incidence Predilection for aorta, coronary, and cerebral arteries Risk factors Controlled Controlled Uncontrolled Uncontrolled Atheroma formations
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 38 Degenerative Diseases Atherosclerosis Formation of atheroma Chronic endothelial injury Chronic endothelial injury Lipid theory Lipid theory Ischemia Signs and symptoms Diagnosis Most common cause of CAD and CVA
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 39 Degenerative Diseases Coronary artery disease Cause Infarct Associated complications Angina pectoris Angina pectoris Single most common cause of death in men and women in U.S.
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 40 Degenerative Diseases Coronary artery disease Risk factors Diagnosis Treatment
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 41 Degenerative Diseases Myocardial infarction (MI) Cause Most common—acute thrombus of coronary artery Most common—acute thrombus of coronary artery Signs and symptoms Early medical intervention Diagnosis Treatment Thrombolytic therapy Thrombolytic therapy PCTA PCTA
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 42 Aneurysms Outpouching of vessel wall Causes Classifications Saccular Cerebral artery Cerebral artery Fusiform Distal abdominal aorta Distal abdominal aorta Dissecting
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 43 Aneurysms
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 44 Aneurysms Abdominal aortic aneurysm Majority of aneurysms Diagnosis Treatment Surgical repair if greater than 6 cm Surgical repair if greater than 6 cm
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 45 Aneurysms Thoracic aortic aneurysm Cause Diagnosis Treatment Surgical repair if greater than 6 cm Surgical repair if greater than 6 cm
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 46 Aneurysms Extremities Popliteal arteries Bilateral Bilateral In conjunction with AAA In conjunction with AAA Diagnosis Diagnosis
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 47 Venous Thrombosis Cause Incidence Phlebitis Thrombus Thrombophlebitis
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 48 Venous Thrombosis Diagnosis Sonography Venography Treatment
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 49 Venous Thrombosis
Mosby items and derived items ©2009, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 50 Pathology Summary Additive Coarctation of aorta Septal defects Tetralogy of Fallot Valvular disease Congestive heart disease Cor pulmonale