Cardiac lipomas are uncommon benign primary cardiac neoplasms although they are considered the commonest non-myxomatous benign primary cardiac tumor 8.
They have no defined age or sex distribution.
They are soft and may grow to a large size without causing ...
Cardiac lymphoma is a rare tumor of the myocardium and/or pericardium. It may be considered as primary or secondary.
Primary cardiac lymphoma is a rare occurrence, representing only 10% of primary malignant cardiac tumors (1% of all primary cardiac tumors).
Secondary involvement ...
Cardiac MRI consists of using MRI to study heart anatomy, physiology, and pathology.
In comparison to other techniques, cardiac MRI offers:
improved soft tissue definition
protocol can be tailored to likely differential diagnoses
a large number of sequences are available
A cardiac MRI can be a more or less frequent examination faced in daily practice also depending on the institution. In general radiological practices and institutions other than cardiac imaging centers, cardiac MRI examinations are not necessarily gladly enlisted into the appointment schedule pa...
Cardiac myxomas, although uncommon are one of the commonest primary cardiac tumors and account for ~50% primary benign cardiac tumors.
Cardiac myxomas are the most common primary cardiac tumor in adults (~50%) but are relatively infrequent in childhood, where cardiac rhabdomyomas...
Cardiac output (CO) and cardiac index (CI) are important hemodynamic parameters characterizing cardiac function and reflecting body metabolism.
Cardiac output (CO) and cardiac index (CI) are used in the evaluation of patients with heart disease and critically ill patients as well as pati...
The cardiac plexus is a plexus of nerves situated at the base of the heart. It is formed by cardiac branches derived from both the sympathetic and parasympathetic nervous systems.
Sympathetic cardiac nerves are derived from T1 to T4 segments and partly from the T5 segment of the ...
The cardiac position in the thorax may be described as:
levocardia: left-sided heart
dextrocardia: right-sided heart
mesocardia: midline heart
These terms purely describe the anatomic position of the left ventricular apex in the chest and their use does not indicate anything about the struct...
Cardiac restraint devices are implantable cardiac devices which aim to reduce ventricular wall stress, improve systolic function and reduce cardiac remodeling.
Cardiac restraint devices act to support the ventricular wall with an elastic mesh network which offers passive pressure to support the...
Cardiac rhabdomyomas are a type of benign myocardial tumor and are considered the most common fetal cardiac tumor. They have a strong association with tuberous sclerosis.
Cardiac rhabdomyomas are often multiple and can represent up to 90% of cardiac tumors in the pediatric populat...
Cardiac sclerosis, or "cardiac cirrhosis" is the end-point of passive hepatic congestion from heart failure.
Causes of cardiac cirrhosis include 1:
ischemic heart disease: ~30%
valvular heart disease: ~25%
restrictive lung disease: ~15%
The American Heart Association (AHA) has published the nomenclature and segmentation of the left ventricular myocardium (the cardiac segmentation model), now widely used for the description of disease-affected myocardial territories and wall function.
There are 17 segments that have a reasonabl...
Cardiac silhouette refers to the outline of the heart as seen on frontal and lateral chest radiographs and forms part of the cardiomediastinal contour. The size and shape of the cardiac silhouette provide useful clues for underlying disease.
From the frontal projection, t...
Cardiac strain or myocardial strain describes the deformation of the cardiac wall or chamber from a relaxed to a contracted condition more precisely the alteration of length in one dimension or spatial orientation.
It can be expressed by a mathematical principle with the following formula 1,2:
Strain imaging is a cardiac imaging technique which detects ventricular deformation patterns and functional abnormalities before they become obvious as regional wall motion abnormalities on conventional cine imaging or echo. It has become more popular lately due to several technological improvem...
Cardiac tamponade is the result of an accumulation of fluid, pus, blood, gas, or benign or malignant neoplastic tissue within the pericardial cavity, which can occur either rapidly or gradually over time, but eventually, results in impaired cardiac output.
This is to be distinguished from a per...
Cardiac tissue characterization is a term for an approach in cardiac imaging used for the evaluation of the myocardial tissue in respect to its inherent properties as opposed to cardiac function e.g. in cine or strain imaging.
In cardiac magnetic resonance imaging it typically comprises the use...
Cardiac tuberculosis refers to the rare infection of the heart with Mycobacterium tuberculosis.
Generally associated with and occurring as a complication of mediastinal and pulmonary tuberculosis.
Pericardial and myocardial involvement is known. Endocardial spread may occur from myo...
The four cardiac valves direct the flow of blood through the heart during the cardiac cycle.
The heart valves are located in the cardiac fibrous skeleton:
two are atrioventricular (AV) valves: the right-sided tricuspid valve (TV) and left-sided mitral (bicuspid) valve (MV)
Cardiac venous malformations (also known as cardiac hemangiomas) consists of a slow flow venous malformation and is composed of numerous non-neoplastic endothelial-lined thin-walled channels with interspersed fat and fibrous septae.
It is important to note that according to newer n...
Quantitative cardiac volumes and measurements can be obtained for the left and right ventricles and include the following 1,2:
interventricular septum thickness
end-diastolic volume (EDV) [mL] and end-diastolic volume index (EDVI) [mL/m2]
end-systolic volume (ESV) [mL]...
Cardiogenic pulmonary edema is a subtype of pulmonary edema where the underlying etiology is due to left ventricular dysfunction.
left heart failure
congestive cardiac failure
Cardiomegaly is a catch-all term to refer to enlargement of the heart, and should not be confused with causes of enlargement of the cardiomediastinal outline, or enlargement of the cardiac silhouette.
There are many etiologies for cardiomegaly:
congestive heart failure
Cardiomyopathy is defined as a "disease of the myocardium with associated cardiac dysfunction" 1. It has been classified according to several systems:
1995 WHO/ISFC cardiomyopathy classification system
Elliott et al. classification system: published by the European Society of Cardiology Workin...
Cardiomyopathy in hemochromatosis refers to an iron overload cardiomyopathy which can occur in those with the condition.
In primary hemochromatosis leading to iron overload, the cardiomyopathy has classically been categorized as an infiltrative cause of restrictive cardiomyopathy. While in thos...
Cardiomyopathy classification separates the various cardiomyopathies into several subtypes. Cardiomyopathy is defined as a "disease of the myocardium with associated cardiac dysfunction".
It was initially classified according to the 1995 World Health Organization / International Society and Fed...
Cardiorenal syndrome refers to an association between cardiac failure and renal failure. It can manifest as a new-onset of renal failure, or the aggravation of a pre-existing one within the ambit of an acute or chronic heart failure exacerbation. sometimes it can occur the other way around.
Cardiovascular (cardiac) shunts are abnormal connections between the pulmonary and systemic circulations. Most commonly they are the result of congenital heart disease.
Blood can either be shunted from the systemic circulation to pulmonary circulation (i.e. 'left-to-right shunt') or ...
Carotid pacemakers, also known as implantable carotid sinus stimulators, are devices that deliver activation energy, via carotid leads, to the carotid baroreceptors. This is sometimes offered for drug-resistant hypertension. The baroreceptors send signals to the brain and the signals are interpr...
The Carpentier classification divides mitral valve regurgitation into three types based on leaflet motion 1:
type I: normal leaflet motion
annular dilation, leaflet perforation
regurgitation jet directed centrally
type II: excessive leaflet motion
papillary muscle rupture, chordal rupture, ...
Pulseless electrical activity is a very disconcerting emergency medical scenario with very high mortality unless its etiology can be quickly ascertained and corrected. A mnemonic to remember the different causes of pulseless electrical activity is:
MAD (triple H) CAT
M: massive pulmo...
Cervical aortic arches are a rare aortic arch anomaly characterized by an elongated, high-lying aortic arch extending at or above the level of the medial ends of the clavicles.
Patients with cervical aortic arch are usually asymptomatic. Symptomatic patients may present w...
Chagas disease, also known as American trypanosomiasis (plural: trypanosomiases), is a tropical parasitic infection with a wide spectrum of clinical manifestations since it can virtually affect any organ, but there are characteristic radiological features.
Chagas disease is endemi...
Chen sign on chest radiography is the prominence of the left basal pulmonary vasculature, compared to the right, seen in valvular pulmonary stenosis. It is due to the asymmetric increase in pulmonary blood flow to the left lung due to preferential blood flow into the left pulmonary artery after ...
This is a basic article for medical students and other non-radiologists
Chest x-ray review is a key competency for medical students, junior doctors and other allied health professionals. Using A, B, C, D, E is a helpful and systematic method for chest x-ray review where C refers to circulation ...
This is a basic article for medical students and other non-radiologists
Chest x-rays are performed frequently in the assessment of a vast number of sick (and potentially very sick) patients.
A chest x-ray can be performed in the radiology department (usually with the patient standing up) or b...
An uncommon anatomic variant present in the right atrium, a Chiari network refers to a filamentous, weblike structure that results from incomplete resorption of the embryologic sinus venosus.
Prevalence estimates for the general population vary widely, ranging from 2% - 10% of ran...
The chordae tendineae (singular: chorda tendinea, is rarely used) are thin strong inelastic fibrous cords that extend from the free edge of the cusps of the atrioventricular valves (the tricuspid and mitral valves) to the apices of the papillary muscles within the right and left ventricles respe...
Chronic thromboembolic pulmonary hypertension (CTEPH) is a distinct subgroup of pulmonary hypertension that most frequently develops following massive or repeated pulmonary embolism.
The term CTEPH should be used for patients with chronic thromboembolic disease and pulmonary hypert...
Cine imaging, a.k.a. cine sequences or cine MRI, are a type of MRI sequence acquired to capture motion.
Cine images are obtained by repeatedly imaging the area of interest for a certain time typically within a single slice, although 3D solutions already exist 3.
For the hear...
The circumflex artery (Cx) is one of the two major coronary arteries that arise from the bifurcation of the left main coronary artery (the other branch being the left anterior descending (LAD) artery).
The circumflex artery can be referred to by multiple terms:
circumflex artery (...
Coaptation refers to a joining or reuniting of two surfaces. This can be in the setting of ends of a broken bone or the edges of a wound or edges of a valve.
There are several described cockade signs in radiology:
cockade sign (intraosseous lipoma)
cockade sign (aorto-left ventricular tunnel) 1
cockade sign (appendicitis) 2
cockade sign (hypertrophic pyloric stenosis) 3
cockade sign (GI tumors) 4
COL4A1-related disorders are a group of autosomal dominant disorders caused by a mutation in the COL4A1 gene.
The exact prevalence is unknown, but the group of disorders is considered to be under-recognized, especially asymptomatic variants 1.
The clinical ...
Congenital absence of the circumflex artery ensues from a lacking development of the circumflex artery within the atrioventricular groove.
Congenital absence of the circumflex artery is a very rare coronary artery anomaly.
Congenital absence of the circumflex artery...
Congenital aortic stenosis broadly refers to a congenital narrowing of the aortic lumen. Although the term can mean narrowing at any point, it often relates to a narrowing of the aortic valve. As a broad group, there can be some overlap with ascending aortic coarctation depending on the definiti...
Congenital cardiovascular anomalies are relatively common, with an incidence of up to 1% if small muscular ventricular septal defects (VSDs) are included. As a group, there is a much greater frequency in syndromic infants and in those that are stillborn.
In a large study in the U...
Congenital coronary artery anomalies (CCAAs) are not common, found only in ~1% (range 0.1-2%) of patients 1,3.The most important finding to look for is the "malignant" course of anomalous coronary artery, i.e. does the artery run between big pulsating objects - right ventricular outflow tract / ...
Congenital coronary ostial stenosis and coronary atresia are congenital coronary artery anomalies of the intrinsic coronary anatomy in which there is either an intrinsic narrowing or an absent of the coronary ostium.
Coronary ostial stenosis and atresia are reportedly extremely ra...
With the advent of echocardiography, and cardiac CT and MRI, the role of chest x-rays in evaluating congenital heart disease has been largely been relegated to one of historical and academic interest, although they continue to crop up in radiology exams. In most instances a definite diagnosis ca...
The diagnosis of congenital heart disease in echocardiography is outside the scope of basic echocardiography, however, several common features may be recognized at the point of care which allow for initial stablization and management before a complete echocardiography exam may be performed.
Congenitally corrected transposition of the great arteries, also known as levo- or L-loop transposition (L-TGA), is a rare cardiovascular anomaly with inversion of the ventricles and great arteries.
This anomaly comprises less than 1% of all congenital heart diseases 1,2,7.
Congenital pulmonary stenosis (CPS) refers to congenital narrowing of the right ventricular outflow tract, pulmonary valve, or pulmonary artery.
See pulmonary valve stenosis for a general discussion about this valvulopathy.
The estimated incidence is 1 in 2000 births.
Congenital pulmonary venolobar syndrome is a condition comprising a rare group of cardiac and pulmonary congenital abnormalities occurring variably in combination. The abnormalities include:
anomalous pulmonary venous drainage
particularly scimitar syndrome with hypogenetic right lung
Congestive cardiac failure (CCF), also known as congestive heart failure (CHF) or simply heart failure, refers to the clinical syndrome caused by inherited or acquired abnormalities of heart structure and function, causing a constellation of symptoms and signs that lead to decreased quality and ...
Conotruncal heart defects are a group of congenital cardiovascular anomalies. They are a leading cause of symptomatic cyanotic cardiac disease diagnosed in utero.
They may account for up to a fifth of all congenital cardiac anomalies diagnosed prenatally 2.
Constrictive pericardial syndromes include 1:
transient constrictive pericarditis
a complication of acute (inflammatory) pericarditis in which the inflamed pericardium causes constrictive hemodynamics
resolution occurs within several weeks
chronic constrictive pericarditis
persistence of c...
Constrictive pericarditis (or perhaps better termed pericardial constriction) is a type of pericarditis which leads to diastolic dysfunction and potential symptoms of right heart failure.
No single demographic is affected as there are numerous causes of constrictive pericarditis....
The conus artery is a small early branch off the right coronary artery (RCA) circulation.
The artery has a variable distribution, but usually supplies a region of the anterior interventricular septum and the conus of the main pulmonary artery (hence its name).
Coronary arterial dominance is defined by the vessel which gives rise to the posterior descending artery (PDA), which supplies the myocardium of the inferior third of the interventricular septum.
Most hearts (80-85%) are right dominant where the PDA is supplied by the right coronary artery (RCA...
Coronary arterial ectasia (CAE) refers to diffuse dilatation of the coronary arteries. Under some classification systems, there is some overlap with the term coronary arterial aneurysms (which is a more focal dilatation).
It is often defined as dilatation of an arterial segment to ...
The coronary arteries arise from the coronary sinuses immediately distal (superior) to the aortic valve and supply the myocardium of the heart with oxygenated blood. The arteries branch to encircle the heart covering its surface with a lacy network, perhaps resembling a slightly crooked crown.
Coronary arteriovenous fistulas (CAVFs) are rare coronary artery anomalies whereby there is a fistula between a coronary artery and, most commonly, the right side of the cardiac circulation.
Although a CAVF, in the strictest sense of the term, implies a communication between the c...
Coronary artery aneurysms are an uncommon, predominantly incidental finding.
Coronary artery aneurysms are most common in men 3, likely reflecting the increased rates of atherosclerosis in men compared to women. Prevalence varies in the literature between 0.1-5% 4.
A coronary artery bypass graft (CABG or CAG) is placed during a surgical procedure to increase blood flow to the myocardium due to coronary stenoses, usually caused by coronary artery disease. Arteries or veins can be grafted during this procedure.
Long term outcome of coronary artery bypass gr...
Coronary artery calcification is a common incidental finding in asymptomatic patients having CT of the thorax for non-cardiac indications as well as being a significant finding on cardiac CT. Coronary artery calcification is a marker of atherosclerotic plaque and thus coronary artery disease ris...
Coronary Artery Calcium Data and Reporting System (CAC-DRS) is a structured reporting scheme for all non-contrast CT scans in the evaluation of coronary artery disease, which can help in communication between clinicians and radiologists. These guidelines have been recommended by the Society of C...
Coronary artery disease (CAD) is primarily due to narrowing of the coronary arteries due to atherosclerosis, which results in myocardial ischemia, and is the leading cause of mortality globally.
Coronary artery disease is asymptomatic in most of the population. When seve...
The Coronary Artery Disease - Reporting and Data System (CAD-RADS) is a standardized findings communication method and clinical decision aid relevant to coronary CT angiography. The system was created by a collaboration of the Society for Cardiovascular Computed Tomography (SCCT), American Colle...
Coronary artery dissection (also known as spontaneous coronary artery dissection or SCAD) is a rare cause of acute coronary syndrome especially in young patients who are otherwise healthy.
Coronary artery dissection occurs mainly in young, otherwise health patients especially in f...
A coronary artery to pulmonary artery fistula is a type of coronary artery fistula where there is a fistula / aberrant communicating vessel between a coronary artery and a pulmonary artery / or pulmonary trunk.
They may account for around 15-30% cases of all coronary arterial fist...
A coronary cameral fistula is a type of coronary artery fistula and is defined as a fistulous communication or communicating vessel from coronary artery into any of the cardiac chambers
It is considered the most common type of coronary artery fistula. They may be are present in le...
Coronary hypoplasia or hypoplastic coronary artery disease (HCAD) is a congenital coronary artery anomaly of intrinsic anatomy and can be defined as one or more coronary arteries being abnormally small or underdeveloped.
Hypoplastic coronary artery disease is described as a rare c...
Coronary in-stent restenosis (ISR) is referred to as an increasing loss of the stented arterial lumen after a percutaneous coronary intervention (PCI) and coronary stent placement which requires revascularization.
However, there are different clinical and angiographic definitions:
Microvascular obstruction (MVO), also known as no-reflow phenomenon, is an established complication encountered in coronary angioplasty for prolonged acute myocardial infarction.
The phenomenon results from obstruction of the myocardial microcirculation, which is composed of vessel...
Coronary MR angiography (coronary MRA) is a developing approach to imaging the coronary arteries.
Advantages of coronary MRA include avoidance of the intravenous iodinated contrast and ionizing radiation used in coronary CT angiography and conventional angiography.
A disadvantage of coronary M...
A coronary ostial dimple is a type of congenital coronary artery anomaly where there is a rudiment of the coronary ostium usually followed more distally by proximal coronary stem atresia.
The coronary sinus is the largest cardiac venous structure. It returns the majority of the blood supply for the left ventricle to the right atrium.
The coronary sinus courses along the posterior wall of the left atrium into the left atrioventricular groove. It normally drains int...
Coronary stents or coronary artery stents are expandable tubular medical meshwork devices used for interventional treatment of coronary artery disease and prevention of negative remodeling and vascular recoil, restenosis as well as abrupt vessel occlusion from local coronary artery dissection af...
Coronary stent thrombosis or scaffold thrombosis refers to a recent acute thrombus or occlusion in a coronary segment previously treated with a coronary stent or scaffold. It is a severe complication of percutaneous coronary intervention (PCI) and a major adverse cardiovascular event.
The coronary veins return deoxygenated blood from the myocardium back to the right atrium. Most venous blood returns via the coronary sinus. Coronary venous anatomy is highly variable, but is generally comprised of three groups:
cardiac veins which drain into the coronary sinus:
great cardiac ...
Cor pulmonale is defined as a failure of the structure and function of the right ventricle in the absence of left ventricular dysfunction. It is caused by an underlying primary disorder of the respiratory system. It has a generally chronic and slowly progressive course, although acute onset or w...
Cor triatriatum is an extremely rare and serious congenital cardiac anomaly.
It is thought to account for ~0.1% of all congenital cardiac anomalies 3,4.
Clinical presentation depends on:
degree of stenosis in the fibromuscular membrane
the integrity of ...
A coumadin ridge, also called warfarin ridge or left lateral ridge, is a band-like embryological remnant in the left atrium between the left superior pulmonary vein and the left atrial appendage. It is considered an anatomical variant.
The ridge is formed by the coalition of the left superior ...
Creatine kinase (CK), also known as creatine phosphokinase (CPK), is a key enzyme, for energy production in mitochondria and muscle tissues. It is important as a diagnostic assay in clinical practice, primarily because inflamed/injured muscle releases creatine kinase into the circulation 1.
The crista terminalis is a smooth muscular ridge in the superior aspect of the right atrium, formed following resorption of the right valve of the sinus venosus. It represents the junction between the sinus venarum, the "smooth" portion of the right atrium derived from the embryologic sinus veno...
A crus (plural: crura) is an anatomical term used for a structure which resembles a leg.
crus (internal capsule)
crus (semicircular duct)
This is a basic article for medical students and other non-radiologists
Chest CT is a computed tomography examination of the thoracic cavity performed for a variety of reasons, from suspected cancer to penetrating chest trauma.
A CT chest can be performed with or without IV contrast and when I...
A number of entities can present as cyanotic congenital heart disease. These can be divided into those with increased (pulmonary plethora) or decreased pulmonary vascularity :
increased pulmonary vascularity
total anomalous pulmonary venous return (TAPVR) (types I and II)
transposition of the...
Danon disease is an X-linked dominant cause of debilitating cardioskeletal myopathy and is a lysosomal storage disorder.
Although considered rare, the exact incidence is unknown 1.
Danon disease is characterized by the triad of 1-4:
Deductive echocardiography is a step-by-step approach in diagnosing and differentiating congenital heart disease.
position of heart
Delayed myocardial enhancement, as seen on cardiac MRI, occurs when gadolinium contrast material seeps into fibrotic or necrotic myocardial tissue. It is due to a number of etiologies, and has variable appearances.
subendocardial enhancement indicates an ischemic etiology
Delayed myocardial enhancement can occur in cardiac MR assessment due to a number of causes.
myocardial ischemia: typically subendocardial and follows a vascular territory 1
non-ischemic dilated cardiomyopathy