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Pericardial lipoma

Pericardial lipomas are slowly growing benign tumors of the pericardium that are asymptomatic unless large in size, where they can cause pressure symptoms. Radiographic features Echocardiography Tends to be echogenic structure adjacent or inside the pericardium. CT Seen as a fatty attenuati...

Pericardial mesothelioma

Pericardial mesothelioma refers to a mesothelioma arising primarily from the pericardium. Epidemiology They are rare and are only thought to account for ~0.7% of all malignant mesotheliomas. There is male to female predominance of approximately 3:1. Clinical presentation The presentation of...

Pericardial recesses

The pericardial recesses are small spaces in the pericardial cavity arising from the transverse pericardial sinus that are formed by the reflections of the pericardium. Pericardial fluid can pool in these recesses, mimicking mediastinal lymph nodes or pathology. There are several pericardial re...

Pericardial space

The pericardial space or cavity is the fluid-filled space in between the parietal and visceral layers of the serous pericardium. In normal conditions it contains only a small amount of serous pericardial fluid, usually 15-20 mL. Related pathology A pericardial effusion is the pathological accu...

Pericardial teratoma

Pericardial teratomas are type of primary pericardial tumor. They are usually diagnosed in infants and neonates. As with all teratomas, they are comprised of contain endodermal, mesodermal and neuroectodermal germinal layers. While they are usually benign tumors, they may be life-threatening du...

Pericardial thickening

Pericardial thickening refers to an abnormally thickened state of the pericardium and may occur in inflammatory (i.e. pericarditis) as well as non-inflammatory situations. Many consider a maximum thickness ~2 mm (as measured on CT/MRI) as the upper limit of normal, with a thickness greater than...

Pericardial tumors

There are a number of tumors that can involve the pericardium. They include primary pericardial tumors primary pericardial mesothelioma pericardial sarcoma(s) pericardial liposarcoma pericardial fibrosarcoma pericardial fibroma primary pericardial lymphoma pericardial hemangioma pericar...

Pericardial window

Pericardial window or fenestration is a procedure performed to create a fistula or "window" from the pericardial space to the pleural space. It is done to allow a pericardial effusion to drain the chest cavity in order to relieve situations with increased pressures such as with cardiac tamponade.

Pericarditis

Pericarditis is defined as inflammation of the pericardium. It is normally found in association with cardiac, thoracic or wider systemic pathology and it is unusual to manifest on its own. Clinical presentation Classically, patients present with abrupt, pleuritic, positional left precordial ch...

Pericardium

The pericardium is a conical, flask-like, fibroserous sac which contains the heart and the roots of the great vessels and defines the middle mediastinum. Gross anatomy The pericardium is made of two sacs in one. The outer sac is the fibrous pericardium and the inner sac is the double-layered ...

Peripartum/postpartum cardiomyopathy

Peripartum/postpartum cardiomyopathy is a dilated cardiomyopathy that may occur in the last trimester of pregnancy through the first several months postpartum. Epidemiology The estimated incidence in the United States ranges from one in 900 to one in 4000 live births, with an increased inciden...

Personalised external aortic root support (PEARS)

Personalised external aortic root support (PEARS) is a procedure is where a computer designed mesh sleeve is manufactured to match the aortic root and aortic morphology of the individual patient and then placed to repair pathological aortic morphology such as those with Marfan syndrome. It was i...

PET-CT indications

PET-CT is a combination of cross-sectional anatomic information provided by CT and the metabolic information provided by positron emission tomography (PET). PET is most commonly performed with 2-[F-18]fluoro-2-deoxy-D-glucose (FDG). Fluorine-18 (F-18) is an unstable radioisotope and has a half-...

Peter Kerley

Sir Peter “PK” Kerley (1900-1979) was a globally-renowned cardiothoracic radiologist who is primarily remembered now for his Kerley lines but in his lifetime was famed for his uncanny imaging diagnostic abilities, co-editing the famous 'A Text-book of X-Ray Diagnosis by British Authors', and co-...

PHACE syndrome

PHACE syndrome, also known as cutaneous hemangioma–vascular complex syndrome or Pascual-Castroviejo type II syndrome, is a phakomatosis that comprises of: P: posterior fossa malformations (e.g. Dandy-Walker malformation) H: hemangiomas A: arterial anomalies C: coarctation of the aorta and ca...

Pigs-in-a-blanket sign

Pigs-in-a-blanket sign refers to the CT appearance of coronary pseudotumors, which are observed in IgG4-related coronary periarteritis. This appears as a soft tissue mass surrounding the involved segment of the coronary artery.

Pink tetralogy of Fallot

Pink tetralogy of Fallot refers to a tetralogy of Fallot in which the degree of right ventricular outflow obstruction is minimal, resulting no significant right to left shunt, and therefore no cyanosis. Symptoms are mild and presentation may be delayed, even into adulthood. See also tetralogy ...

Pneumopericardium

Pneumopericardium represents gas (usually air) within the pericardium, thus surrounding the heart. Pathology Etiology Underlying causes include: positive pressure ventilation thoracic surgery/pericardial fluid drainage penetrating trauma blunt trauma (rare) infectious pericarditis with ...

Point-of-care ultrasound (curriculum)

The point-of-care ultrasound (PoCUS) curriculum is one of our curriculum articles and aims to be a collection of articles that represent the core applications of ultrasonography in a point-of-care setting. Point-of-care ultrasound refers to ultrasonography which may be simultaneously performed,...

Polyarteritis nodosa

Polyarteritis nodosa (PAN) is a systemic inflammatory necrotizing vasculitis that involves small to medium-sized arteries (larger than arterioles). Epidemiology PAN is more common in males and typically presents around the 5th to 7th decades. 20-30% of patients are hepatitis B antigen positiv...

Polysplenia syndrome

Polysplenia syndrome, also known as left isomerism, is a type of heterotaxy syndrome where there are multiple spleens congenitally as part of left-sided isomerism. Epidemiology Polysplenia is seen predominantly in female patients. It is usually diagnosed in childhood or adulthood, later than a...

Porcelain aorta

A porcelain aorta refers to circumferential calcification of the ascending aorta. This finding is important to recognize in the preoperative evaluation of cardiac surgery as it complicates cardiac surgeries that require cross-clamping or accessing the aorta (such as open aortic valve replacement...

Porcelain left atrium

Porcelain left atrium, also known as coconut left atrium, is a term used when a large part of or the entire left atrial wall becomes calcified. It can occur as a rare consequence of endocarditis (with underlying rheumatic heart disease). It has also been described in the setting of end-stage ren...

Postcaval recess

The postcaval recess is one of the pericardial recesses forming a small space within the pericardium, which arises from the transverse pericardial sinus. It is located posterior to the superior vena cava and superior to the right superior pulmonary vein. It may mimic mediastinal lymphadenopathy...

Posterior left ventricular artery

The posterior left ventricular (PLV) artery, also known as the posterolateral artery (PLA), is a terminal branch of the coronary arterial system supplying the inferior portion of the heart. It usually arises from the right coronary artery (in a right dominant circulation) but can less commonly a...

Posterior vein of the left ventricle

The posterior vein of the left ventricle is a vein of the heart which courses over the inferior wall of the left ventricle and drains into the coronary sinus to the left of where the middle cardiac vein drains into the sinus. It drains, not unsurprisingly, the inferior wall of the left ventricle.

Postmortem changes - cardiovascular

Cardiovascular postmortem changes refer to the normal appearances of the cardiovascular system on postmortem imaging. Radiographic features CT hyperdensity of the aortic wall 1,2 hypostasis of blood intravascularly 3 dilatation of the right atrium of the heart 1 dilatation of the superior...

Post-sternotomy complications

Post-sternotomy complications comprise of a varied range problem that can occur at varying durations after a median sternotomy. Imaging playing in detection and aiding management. Epidemiology Complication rates for median sternotomy have been reported to range from 0.5-5%, with mortality rate...

Pott shunt

A Pott shunt is a form of palliative surgery performed in patients with tetralogy of Fallot prior to the ability to repair the defect. It consists of a shunt formed between the descending thoracic aorta and the left pulmonary artery. This does not relieve the right ventricular outflow obstructi...

Primary benign cardiac tumors

Primary benign cardiac tumors are much less common than secondary metastatic deposits. However they are more likely when a cardiac mass is seen outside of the setting of terminal metastatic disease. Tumors include 1-2: cardiac myxoma most common in adults accounts for ~50% of all primary beni...

Primary cardiac tumors

Primary cardiac tumors are uncommon and comprise only a small minority of all tumors that involve the heart: most are mediastinal or lung tumors that extend through the pericardium and into the heart, or metastases 1. Epidemiology Primary cardiac tumors have an estimated autopsy prevalence of ...

Primary malignant cardiac tumors

Primary malignant cardiac tumors are rare, and account for only ~25% of primary cardiac tumors, and only a small proportion of all malignant tumors which involve the heart: direct extension of adjacent tumors or metastatic deposits are far more common. Pathology Histologcal types include 1: ...

Prosthetic cardiac valves on chest x-ray (an approach)

Prosthetic cardiac valves are a routine finding on chest X-ray. The frequency and degree of exposure is greatest in larger hospitals with cardiothoracic centers, however, prosthetic valves are commonplace universally. Recognition of which valve has been replaced, any other related cardiothoraci...

Prosthetic heart valve

Prosthetic heart valves are common. The four valves of the heart may all be surgically replaced. However, the aortic and mitral valves are the most commonly replaced. Replacements may be tissue or metallic valves, only the latter being visualized on imaging investigations. Sometimes the annulus...

Pseudocoarctation of the aorta

Pseudocoarctation of the aorta is a very rare anomaly characterized by kinking or buckling of the descending aorta at the level of the ligamentum arteriosum without a pressure gradient across the lesion. Pathology It is thought to be of congenital origin, and characterized by elongation and ki...

Pulmonary artery atresia

Pulmonary artery atresia (or sometimes known as pulmonary atresia) is a congenital cardiovascular anomaly in which there is complete disruption between the right ventricular outflow tract (RVOT) and the pulmonary trunk. Epidemiology The estimated incidence is 1 in 10,000 births. Pathology Th...

Pulmonary artery banding

Pulmonary artery banding is a palliative surgical procedure used to decrease excessive pulmonary blood flow. It is usually used for neonates and infants with left-to-right shunts unable to withstand complete surgical correction. Some indications include: single ventricle multiple ventricula...

Pulmonary atresia with intact interventricular septum

Pulmonary atresia with intact interventricular septum (PA-IVS) is a subtype of pulmonary atresia that presents as cyanotic congenital heart disease. Pathology PA-IVS is the combination of obstruction of the pulmonary outflow tract from pulmonary valve atresia without a ventricular septal defe...

Pulmonary hypertension (2003 classification)

There are numerous causes of pulmonary hypertension, and thus not surprisingly there have been many classification systems. In 2003, the 3rd World Symposium on PAH met in Venice and produced an updated classification system (this has been further revised in the Dana Point classification of pulm...

Pulmonary hypertension (2008 classification)

The classification system for pulmonary hypertension was revised at the 4th World Symposium on Pulmonary Hypertension held in Dana Point, California, in 2008 1. This system is as follows: group 1: pulmonary arterial hypertension 1.1: idiopathic pulmonary arterial hypertension 1.2: heritable ...

Pulmonary hypertension (2013 classification)

In 2013, the 5th World Symposium on pulmonary hypertension took place in Nice, France and modified the classification system for pulmonary hypertension. The modified system divides pulmonary hypertension into five groups: group 1: pulmonary arterial hypertension (disorders of the pulmonary ar...

Pulmonary hypertension (differential)

Pulmonary hypertension has many causes, and these can be divided in many ways. A simple and systematic approach is to proceed along the cardiopulmonary pulmonary circulation, as causes are found at each site (for a more official classification system see 2003 third world symposium on pulmonary a...

Pulmonary interstitial edema

Pulmonary interstitial edema represents a form of pulmonary edema resulting from pathological fluid buildup in the interstitial spaces due to increased hydrostatic driving pressure. Pathology Interstitial lung edema arises almost exclusively due to an increase of the pulmonary capillary hydros...

Pulmonary edema

Pulmonary edema is a broad descriptive term and is usually defined as an abnormal accumulation of fluid in the extravascular compartments of the lung 1. Clinical presentation The clinical presentation of pulmonary edema includes: acute breathlessness orthopnea paroxysmal nocturnal dyspnea ...

Pulmonary tumor embolism

Pulmonary tumor embolism refers to a specific type of pulmonary embolism where the embolic constituents comprise of tumor components / particles or tumor thrombus. It can either be microscopic or macroscopic. Pathology Microscopic tumor embolism Thought to occur from two distinct pathophysiol...

Pulmonary valve

The pulmonary valve (PV) is one of the four cardiac valves. It is the semilunar valve that allows blood to exit the right ventricle (RV). It opens during systole and closes during diastole. The valve has anterior, left and right cusps, the bases of which attach around the valve orifice to a fib...

Pulmonary valve regurgitation

Pulmonary valve regurgitation, also known as pulmonary valve insufficiency or pulmonary valve incompetence, is a valvulopathy that describes leaking of the pulmonary valve diastole that causes blood to flow in the reverse direction from the pulmonary trunk and into the right ventricle. Epidemio...

Pulmonary valve stenosis

Pulmonary valve stenosis, or pulmonic valve stenosis, is a valvulopathy that describes the narrowing of the opening of the pulmonary valve between the pulmonary trunk and the right ventricle. Epidemiology Pulmonary stenosis is nearly always (95%) congenital, and therefore primarily affects the...

Pulmonary vein stenosis

Pulmonary vein stenosis refers to a spectrum of conditions characterized by narrowing of the pulmonary veins. It can be congenital or acquired. primary pulmonary vein stenosis - occurs in children secondary pulmonary vein stenosis - occurs in adults and usually associated with some identifiabl...

Pulseless electrical activity

The diagnosis of pulseless electrical activity (PEA), also known as electromechanical dissociation (EMD) refers to the presence during cardiac arrest of electrical activity of the heart, in the absence of a ventricular tachyarrhythmia, but no measurable cardiac output 1,2. PEA is one of the non-...

Pyrexia

Pyrexia (or fever) is a clinical sign, indicated by an abnormally elevated core body temperature, which is defined by several medical societies as ≥38.3°C (≥101°F). The temperature elevation may be persistent or episodic. The commonest cause of fever is infection, in one study of hospital inpati...

Quadricuspid aortic valve

Quadricuspid aortic valve (QAV) is a rare cardiac valvular anomaly where the aortic valve has four cusps, instead of the usual three. Epidemiology The estimated incidence on necropsy at ~1 in 8,000. While the incidence of QAV on 2D echocardiography has been reported to range between 0.01-0.04%...

Radiation-induced heart disease

Radiation-induced heart disease, also known as radiation cardiotoxicity, describes an uncommon constellation of potential cardiac complications of thoracic radiotherapy. Epidemiology The demographics of patients affected by radiation-induced heart disease are those of the underlying condition ...

Raghib syndrome

Raghib syndrome is a rare developmental complex. It consists of: persistence of the left superior vena cava coronary sinus ostial atresia atrial septal defect It has also been associated with other congenital malformations including ventricular septal defects, enlargement of the tricuspid an...

Rapid ultrasound in shock

The rapid ultrasound in shock (RUSH) protocol is a structured point-of-care ultrasound (POCUS) examination performed at the time of presentation of a shocked patient. It is a more detailed and longer exam than the FAST scan, with the aim to differentiate between hypovolemic, cardiogenic, obstruc...

RASopathy

RASopathies are a class of developmental disorders caused by germline mutations in genes that encode for components or regulators of the Ras/mitogen-activated protein kinase (MAPK) pathway. Epidemiology As a group, RASopathies represent one of the most common malformation syndromes, with an in...

Rastelli procedure

The Rastelli procedure is a surgical procedure to correct certain combinations of cardiovascular defects in patients with cyanotic congenital heart disease. Rationale The operation is based on a redirection of ventricular outflows using an intracardiac baffle that tunnels the left ventricle to...

Restrictive cardiomyopathy

Restrictive cardiomyopathy is the least common subtype of cardiomyopathy and is characterized by a marked decrease in ventricular compliance. Clinical presentation Patients can present with symptoms and signs of left ventricular failure and/or right ventricular failure 9. Pathology It is p...

Rhabdomyosarcoma (cardiac)

Cardiac rhabdomyosarcoma is a muscular tumor that arises in the heart. Epidemiology They account for only 4-7% of cardiac sarcomas overall but are the most common cardiac malignancy in infants and children. There is a slight male predilection. Pathology Location Cardiac rhabdomyosarcoma hav...

Rheumatic fever

Rheumatic fever is an illness caused by an immunological reaction following group A streptococcal infection. Epidemiology Risk factors include: children and adolescents aged 5 to 15 years developing nations where antibiotic prescription is low 1 poverty, overcrowding Clinical presentation...

Rheumatic heart disease

Rheumatic heart disease (not to be confused with rheumatoid heart disease) may refer to either the acute cardiac involvement or chronic cardiac sequelae following rheumatic fever. Carditis is a major Jones criterion of rheumatic fever. Epidemiology Risk factors include: socioeconomic factors ...

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune multisystemic inflammatory disease which affects many organs but predominantly attacks the synovial tissues and joints. Epidemiology The overall prevalence is 0.5-1% and the disease is 2-3 times more common in women 1. Onset is generally in ad...

Right atrial enlargement

Right atrial enlargement is less common, and harder to delineate on chest radiograph, than left atrial enlargement. Pathology Causes Enlargement of the right atrium can result from a number of conditions, including: raised right ventricular pressures pulmonary arterial hypertension cor pul...

Right atrial line

The right atrial (RA) line monitors RA pressure and is indicative of right ventricular function, preload and afterload. The RA line enters the right atrium through the right atrial appendage, and always exits the right side of the chest medial to the left atrial line. It is typically a double lu...

Right atrium

The right atrium (RA) (plural: atria) is one of the four chambers of the human heart, and is the first chamber to receive deoxygenated blood returning from the body. It plays an important role in originating and regulating the conduction of the heart. Gross anatomy The right atrium receives de...

Right coronary artery

The right coronary artery (RCA) is one of the two main coronary arteries that supply the heart with oxygenated blood. Gross anatomy Origin It is a branch of the ascending aorta, with its normal origin in the right aortic sinus, just superior to the aortic valve Course The RCA courses to th...

Right heart strain

Right heart strain (or more precisely right ventricular strain) is a term given to denote the presence of right ventricular dysfunction usually in the absence of an underlying cardiomyopathy. It can manifest as an acute right heart syndrome. Pathology Right heart strain can often occur as a re...

Right marginal artery

The right marginal artery, also known as the right intermediate atrial branch, supplies the surrounding right atrial tissues 1,2 and, in 10-15% of cases, provides the main arterial supply to the sinus node 3,4. Terminology It also sometimes known as a the acute marginal artery or margo acutus ...

Right pulmonary venous recess

The right pulmonary venous recess is one of the pericardial recesses forming a small space within the pericardium. It arises from the pericardial cavity proper located between the right superior and inferior pulmonary veins, posterior to the left atrium. It invaginates towards the oblique perica...

Right pulmonic recess

The right pulmonic recess is one of the pericardial recesses forming a small space within the pericardium, which arises from the transverse pericardial sinus. It is located posterior to the right pulmonary artery and anterior to the esophagus. It may mimic mediastinal lymphadenopathy or a bronc...

Right-to-left shunt (mnemonic)

A useful mnemonic to remember the differential diagnoses associated with right-to-left cardiovascular shunts is: 1-5 Mnemonic 1: a combination vessel; truncus arteriosus 2: number of arteries involved; transposition of the great arteries 3: "tri-" means 3, the number of leaflets involved; t...

Right ventricle

The right ventricle (RV) is the most anterior of the four heart chambers. It receives deoxygenated blood from the right atrium (RA) and pumps it into the pulmonary circulation. During diastole, blood enters the right ventricle through the atrioventricular orifice through an open tricuspid valve ...

Right ventricular dysfunction

Right ventricular dysfunction usually results from either pressure overload, volume overload, or a combination. It occurs in a number of clinical scenarios, including: pressure overload cardiomyopathies: ischemic, congenital valvular heart disease arrhythmias sepsis It can manifest as ...

Right ventricular enlargement

Right ventricular enlargement (also known as right ventricular dilatation (RVD)) can be the result of a number of conditions, including: pulmonary valve stenosis pulmonary arterial hypertension atrial septal defect (ASD) ventricular septal defect (VSD) tricuspid regurgitation dilated card...

Right ventricular false tendons

Right ventricular false tendons (RFTs), also known as right ventricular muscular bands, are a much less well-known entity than left ventricular false tendons (LFTs). They are fibromuscular structures that arise from the inner trabeculated myocardial layer of the right ventricle, with a range of ...

Right ventricular function (point of care ultrasound)

Right ventricular function is often measured in point-of-care ultrasonography as a composite of the right ventricular size, wall measurements, and contractile efforts. Terminology The right ventricle (RV) can be anatomically divided into an inflow portion, an outflow portion, and an apex. Con...

Right ventricular outflow tract

The right ventricular outflow tract (RVOT) refers to the region of blood outlfow from the right ventricle between the supraventricular crest and the pulmonary valve. It is comprised of the conus arteriosus (infundibulum), ventricular septum and right ventricular free wall. It is commonly assesse...

Right ventricular outflow tract view (fetal echocardiogram)

The right ventricular outflow tract (RVOT) view (or three vessel view/3VV) is one of the standard views in a fetal echocardiogram. It principally assesses the right ventricular outflow tract. It is a long axis view of the heart, highlighting the path from the right ventricle into the pulmonary t...

Ritscher-Schinzel syndrome

Ritscher-Schinzel syndrome (RTSC), also known as 3C (cranio-cerebello-cardiac) syndrome, is a rare entity with a variable spectrum of CNS (primarily cerebellar), craniofacial, and congenital heart defects. Clinical presentation craniofacial cleft palate ocular coloboma prominent occiput lo...

Ross procedure

Ross procedure involves the use of a pulmonary homograft for surgical aortic valve replacement. Indications It can be used to treat a broad array of aortic valve pathologies, often aortic stenosis. Contraindications multivessel coronary artery disease multiple valvular pathologies in which...

Saddle pulmonary embolism

Saddle pulmonary embolism commonly refers to a large pulmonary embolism that straddles the bifurcation of the pulmonary trunk, extending into the left and right pulmonary arteries. If large enough, it can completely obstruct both left and right pulmonary arteries resulting in right heart failur...

Sano shunt

The Sano shunt is a palliative surgical technique sometimes used as a step in Norwood procedure for hypoplastic left heart syndrome. The procedure involves placement of an extracardiac conduit between the right ventricle and main pulmonary artery stump. This technique prevents the reduced diast...

Sarcoidosis (cardiac manifestations)

Cardiac involvement of sarcoidosis is a manifestation of sarcoidosis which is often asymptomatic, although can be associated with high mortality 8. Autopsy studies show prevalence of ~25% cardiac involvement, yet only 5-10% are found symptomatic 1,2. Sarcoidosis is a multisystem disorder chara...

Scleroderma

Scleroderma, also known as systemic sclerosis, is an autoimmune connective tissue disorder characterized by multisystem fibrosis and soft tissue calcification. As such, it affects many separate organ systems, which are discussed separately: musculoskeletal manifestations of scleroderma pulmona...

Scleroderma (cardiac manifestations)

Cardiac manifestations of scleroderma are highly variable, seen in approximately 15% of patients and are associated with a poor prognosis 2. For a discussion of scleroderma in general, refer to parent article: scleroderma. Clinical presentation Patients may present with: myocardial infarctio...

Secondary malignant cardiac tumor

Secondary malignant cardiac tumors or cardiac metastases refer to a secondary malignant tumor involving any structural component of the heart. It represents spread of a primary neoplasm via lymphatic, haematogenous, or endovascular pathways, or potentially by direct extension from an adjacent ti...

Selenium deficiency

Selenium deficiency (or hyposelenemia) when severe may present with arthritic and cardiac-related symptoms. Epidemiology Up to one billion people globally are thought to have some degree of selenium deficiency. Phenylketonuria patients are more likely to experience selenium deficiency as man...

Senning repair

The Senning repair is one of two "atrial switch" procedures used to functionally correct transposition of the great arteries (the other being the Mustard repair). The two repairs share a similar fundamental principle. Systemic blood flow is redirected away from the right ventricle and toward t...

Septal bounce

Septal bounce is a sign of ventricular interdependence on echocardiography, cardiac CT, and cardiac MRI, manifested by paradoxical interventricular septal movement during early diastole (i.e. initial septal movement towards and then away from the left ventricle) seen mainly in constrictive peric...

Septal branches of the left anterior descending artery

The septal branches of the left anterior descending artery supply blood flow to the interventricular septum of the heart. Origin These are branches from the left anterior descending artery. Supply They provide the main blood supply to the anterior interventricular septum. A smaller posterior...

Septal flash

Septal flash, also known as septal beaking, is a sign of interventricular dyssynchrony seen on echocardiography or cinematographic cardiac CT/MRI. It represents an abnormal rapid movement pattern of the interventricular septum during pre-ejection systole (i.e. isovolumic contraction): septal mo...

Shepherd's crook right coronary artery

A shepherd’s crook right coronary artery is variant in the terms of the course of the right coronary artery. While the RCA origin is normal it is characterized by a tortuous and high course, usually just after its origin from the aorta. Its prevalence is estimated at approximately 5%. While ofte...

Shmoo sign

Shmoo sign refers to the appearance of a prominent, rounded left ventricle and dilated aorta on a plain AP chest radiograph giving the appearance of Shmoo, a fictional cartoon character in the comic strip Li'l Abner, which first appeared in 1948. This sign is indicative of left ventricular enlar...

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