Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

656 results found
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Lipomatous metaplasia of the myocardium

Lipomatous metaplasia of the myocardium is a phenomenon where there is fat deposition within the myocardium. It is often seen following a myocardial infarction but can also rarely been seen in conditions such as arrhythmogenic right ventricular dysplasia. Pathology The exact etiology of lipoma...
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Lutembacher syndrome

Lutembacher syndrome refers to the association of an atrial septal defect (ASD) with mitral stenosis.  Both the defects can be either congenital or acquired. History and etymology It is named after Rene Lutembacher 4.
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Lyme disease

Lyme disease, also known as borreliosis, is a condition caused by the bacteria Borrelia burgdorferi, with infection being via the ixodid tick.  Terminology Controversy around Lyme disease centers on chronic infection with some authors doubting its existence 3. There are some terms that help di...
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Major adverse cardiovascular event

Major adverse cardiovascular event (MACE) refers to a combined or composite clinical endpoint that is used for outcome evaluations in clinical trials for cardiovascular research intended as a measure of safety and effectiveness and does not have a specific definition. In the setting relevant fo...
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Major aortopulmonary collateral arteries

Major aortopulmonary collateral arteries (MAPCAs) are persistent tortuous fetal arteries that arise from the descending aorta and supply blood to pulmonary arteries in the lungs usually at the posterior aspect of hilum. Pathology Embryologically, the intersegmental arteries regress with the no...
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Marfan syndrome

Marfan syndrome is a multisystem connective tissue disease caused by a defect in the protein fibrillin 1, encoded by the FBN1 gene. Cardiovascular involvement with aortic root dilatation and dissection is the most feared complication of the disease. Epidemiology The estimated prevalence is aro...
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McConnell's sign (echocardiography)

The McConnell's sign describes a regional pattern of acute right ventricular dysfunction on transthoracic echocardiography first observed in a cohort of patients with acute pulmonary thromboembolism. In contrast to the global wall motion abnormalities observed in chronic right ventricular dysfun...
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Mediastinitis

Mediastinitis by definition refers to inflammation of the connective tissues and fat within the mediastinum.  In clinical practice; mediastinitis is generally used to refer to acute mediastinitis, resulting from bacterial infection within the mediastinum. This is considered a serious and potent...
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Mediastinum (ITMIG classification)

The International Thymic Malignancy Interest Group (ITMIG) classification of mediastinal compartments was developed to reflect a division of the mediastinum based on cross-sectional imaging. It was in part an effort to consolidate prior discrepant classification systems in use by different medic...
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Medical devices in the thorax

Medical devices in the thorax are regularly observed by radiologists when reviewing radiographs and CTs. Extrathoracic devices tubing, clamps, syringes, scissors, lying on or under the patient rubber sheets, foam mattresses, clothing, hair braids, nipple piercings, etc. may also be visible T...
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Metabolic syndrome

The metabolic syndrome, also known as syndrome X, is a set of five conditions, which together increase a patient's risk of developing cardiovascular disease 1. Clinical presentation There are five central components of metabolic syndrome: hyperinsulinemia impaired glucose tolerance dyslipid...
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Metaplasia

Metaplasia is a general pathology term that refers to process when one cell type is replaced by another. It usually occurs in the context of a changed cellular environment to which the new cell type is better adapted 1. Examples include 2-5: Barrett esophagus: normal squamous epithelium replace...
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Middle cardiac vein

The middle cardiac vein or posterior interventricular vein is a vein of the heart which accompanies the posterior interventricular artery. It courses in the posterior interventricular groove and drains directly into the coronary sinus close to it’s termination. It drains the posterior wall of bo...
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Milking effect

Milking effect phenomenon is a pathognomonic angiographic finding in myocardial bridging of coronary arteries. Systolic compression of coronary vessels with partial or complete decompression during diastole is described as milking effect. Its significance lies in:  increased risk of thrombus fo...
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Miminally invasive direct coronary artery bypass

Minimally invasive direct coronary artery bypass (MIDCAB) is a novel method for bypassing diseased coronary arteries that can replace open coronary artery bypass grafts (CABG) in certain situations, most commonly when bypassing the left anterior descending artery (LAD) with a left internal thora...
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Mistletoe sign

The mistletoe sign refers to solid enhancing perivascular masses around the coronary arteries in the presence of idiopathic retroperitoneal fibrosis (Ormond's disease).The presence of the mistletoe sign on cardiac MRI and coronary CT angiography is relatively rare, but it might be a characterist...
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Mitraclip device

A MitraClip™ is a device for percutaneous mitral valve repair. It is a percutaneous edge-to-edge attachment system that mimics the surgical procedure. This technique creates a tissue bridge between the anterior and posterior leaflets employing one clip deployed through trans-septal catheterizati...
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Mitral annular calcification

Mitral annular calcification (MAC) refers to the deposition of calcium (along with lipid) in the annular fibrosa of the mitral valve. Epidemiology Annular calcification is seen in up to 35% of elderly patients. It is common in females over 65 years, in those with myxomatous degeneration of the...
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Mitral annular plane systolic excursion

Mitral annular plane systolic excursion (MAPSE) refers to the displacement of the mitral valvular plane in the z-direction and reflects left ventricular longitudinal contraction or shortening, which has been attributed to account for about 60% of the stroke volume 1. Terminology Mitral annular...
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Mitral valve

The mitral valve (MV) (or bicuspid valve) is one of the four cardiac valves. It is the atrioventricular valve that allows blood to flow from the left atrium to the left ventricle. It opens during diastole and closes during systole. The valve has anterior and posterior leaflets (cusps), the bases...
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Mitral valve calcification

Mitral valve calcification can refer to 1 mitral annular calcification (MAC) or mitral valve leaflet calcification (MVL)
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Mitral valve disease

Mitral valve disease mostly comprises two main functional abnormalities, which can occur in isolation or in combination: mitral regurgitation mitral stenosis In addition, other pathologies that affect the mitral valve include: mitral valve prolapse mitral annular calcification mitral valve...
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Mitral valve prolapse

Mitral valve prolapse (MVP), also known as Barlow syndrome, is often defined as systolic bowing of the mitral leaflet more than 2 mm beyond the annular plane into the atrium 1. It is a common cause of mitral regurgitation (considered most frequent cause of severe non-ischemic mitral regurgitatio...
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Mitral valve regurgitation

Mitral valve regurgitation, also known as mitral valve insufficiency or mitral valve incompetence, is a valvulopathy that describes leaking of the mitral valve during systole that causes blood to flow in the reverse direction from the left ventricle into the left atrium. Epidemiology According...
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Mitral valve stenosis

Mitral valve stenosis is a valvulopathy that describes narrowing of the opening of the mitral valve between the left ventricle and the left atrium. Epidemiology Mitral stenosis is seen more commonly in women and in countries, generally developing nations, where rheumatic fever is common 1. Cl...
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Moderator band

The moderator band, also called the septomarginal trabecula, is a consistent structure in the morphologic right ventricle and can be helpful as a landmark in situations where the ventricles may be ambiguous (i.e. in some forms of congenital heart disease). The term "septomarginal" is descriptiv...
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Moguls of the heart

The 'moguls of the heart' refer to the bulges of the cardiomediastinal contour on frontal chest radiographs. The cardiomediastinal bulges are likened to skiing moguls (bumps of packed snow on a mountainside sculptured by turning skis). Awareness of their usual locations and etiologies is helpful...
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MR feature tracking

MR feature tracking refers to an MRI based post-processing method, used on normal cine SFFP sequences for the analysis of myocardial deformation and the determination of myocardial strain parameters. Methodology MRI feature tracking is a two-dimensional software algorithm applied on standard c...
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MR tagging

Cardiac MR tagging or myocardial tagging refers to a MRI based acquisition method designed for myocardial deformation analysis. Methodology The method exploits tissue magnetization as a tissue property. A local magnetic saturation grid of dark lined tissue markers known as tags are induced ont...
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Mustard repair

The Mustard repair is a technique to correct transposition of the great arteries (TGA), and involves: resection of atrial septum creation of an atrial baffle with a prosthetic material usually. 1,2 Rationale Transposition of the great arteries involves a discordance between the ventricles a...
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Myocardial area at risk

Myocardial area at risk (AAR) is defined by the ischemic proportion of the myocardium after coronary occlusion and reflects the potential size of the myocardial infarction 1-9. Usage The assessment of myocardial area at risk is an important measure in the evaluation of the potentially salvagea...
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Myocardial bridging of the coronary arteries

Myocardial bridging is a common congenital anomaly of the coronary arteries where a coronary artery courses through the myocardium.  Epidemiology It is found approximately in 20-30% of the adult population in autopsy studies. The incidence in coronary angiograms is between 2-15% and can be eas...
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Myocardial crypts

Myocardial crypts (or myocardial clefts or fissures) refer to discrete clefts or fissures in otherwise compacted myocardium of the left ventricle. They are thought to represent a distinctive morphological expression of hypertrophic cardiomyopathy, occurring with different frequency in these pati...
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Myocardial fibrosis

Myocardial fibrosis refers to an increase in collagen volume within the extracellular interstitium 1-3. Clinical presentation Myocardial fibrosis leads to diastolic and or systolic dysfunction and patients can present with symptoms associated with cardiac insufficiency arrhythmias such as dysp...
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Myocardial infarction

Myocardial infarction (MI), colloquially known as a heart attack, an acute coronary syndrome, results from interruption of myocardial blood flow and resultant ischemia and is a leading cause of death worldwide.  Epidemiology Risk factors male > females age >45 years for males >55 years for...
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Myocardial infarction with non-obstructive coronary arteries

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is referred to as a syndrome characterized by the clinical characteristics of myocardial infarction but with normal coronary arteries or no significant coronary stenosis on coronary angiography. Epidemiology The suggested pr...
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Myocardial injury

Myocardial injury or myocardial necrosis refers to the cell death of cardiomyocytes and is defined by an elevation of cadiac troponin values. It is not only considered a prerequisite for the diagnosis of myocardial infarction but also an entity in itself and can arise from non-ischemic or non-ca...
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Myocardial ischemia

Myocardial ischemia refers to the result of a mismatch in myocardial oxygen supply and demand as a consequence of the cessation of blood flow resulting in reversible injury or myocardial cell death if prolonged associated with a loss of contractile function. Epidemiology The total prevalence o...
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Myocardial mapping

Myocardial mapping or parametric mapping of the heart is one of various magnetic resonance imaging techniques, which has evolved and been increasingly used in the last decade for non-invasive tissue characterization of the myocardium 1-5. Unlike normal T1-, T2- or T2*- images, parametric mapping...
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Myocardial edema

Myocardial edema refers to an increased water content of the myocardium particularly within the extracellular interstitium 1. Clinical presentation Myocardial edema often reflects an acute or subacute cardiac event, most often either ischemic or inflammatory and thus can be associated with che...
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Myocardial perfusion and viability

Myocardial perfusion and viability assessment is important for many reasons: to diagnose, locate and grade the severity of coronary artery disease to identify candidates who would benefit from revascularization to evaluate response to revascularization Terminology Stunned myocardium Stunne...
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Myocardial salvage

Myocardial salvage is referred to as the reversibly injured myocardium in a setting of myocardial ischemia and/or myocardial infarction, which remains non-infarcted after reperfusion 1-7. Usage The assessment of myocardial salvage is an important measure in the evaluation of the efficacy of th...
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Myocardial scar tissue

Myocardial scar tissue is referred to as the final result and pathological correlate of myocardial infarction and develops from the infarcted tissue. Terminology Myocardial scar tissue is the result of replacement fibrosis and is also called non-viable myocardium even though the latter is a mi...
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Myocardial viability protocol (MRI)

The MRI myocardial viability protocol encompasses a set of different MRI sequences for the assessment of myocardial viability. Note: This article aims to frame a general concept of a cardiac MRI protocol in the setting of acute or chronic myocardial infarction.  Protocol specifics will vary de...
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Myocarditis

Myocarditis (rare plural: myocarditides) is a general term referring to inflammation of the myocardium.  Clinical presentation Clinical presentation is variable in severity, ranging from asymptomatic to cardiogenic shock, but it typically is associated with other viral symptoms, including feve...
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Myocarditis protocol (MRI)

The MRI myocarditis protocol encompasses a set of different MRI sequences for the cardiac assessment in case of suspected myocardial inflammation. Note: This article aims to frame a general concept of a cardiac MRI protocol in the above setting.  Protocol specifics will vary depending on addit...
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Myocardium

The myocardium defines the middle layer of the cardiac wall between the endocardium and the pericardium and forms the muscular part of the heart. Gross anatomy The myocardium represents the middle layer of the cardiac wall. It is located between the endocardium and the epicardial layer of the ...
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Napkin ring sign (disambiguation)

The napkin ring sign may refer to either of the following imaging findings: napkin ring sign (colon): colonic stenosis such as due to colon cancer napkin ring sign (coronary): coronary artery vulnerable plaque A napkin ring is a decorative household item used in some Western societies to hold...
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Napkin-ring sign (heart)

The napkin-ring sign is a feature of high-risk coronary artery atherosclerotic plaque on CT coronary angiogram (coronary CTA). It has been shown to possess a high predictive value in predicting future cardiac events and is considered one of the imaging correlates of an unstable plaque.  It is n...
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Neoplastic pericardial disease

Neoplastic pericardial disease, neoplastic pericardial involvement or neoplastic pericarditis refers to a pericardial infiltration by tumor cells usually associated with a variably sized pericardial effusion and is a form of non-infectious pericarditis. It needs to be differentiated from other c...
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Nonbacterial thrombotic endocarditis

Nonbacterial thrombotic endocarditis (NBTE), also referred as marantic endocarditis, refers to fibrin and platelets aggregations on previously undamaged heart valves, in patients without bacteremia. The condition is seen in patients with advanced stage malignancies and is related to episodes of ...
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Non-cardiogenic pulmonary edema

Non-cardiogenic pulmonary edema is a classification of pulmonary edema where the underlying etiology is not due to left ventricular dysfunction. Causes include: fluid overload pulmonary edema with acute asthma post-obstructive pulmonary edema/postintubation pulmonary edema/negative pressure ...
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Non-compaction of the left ventricle

Non-compaction of the left ventricle, also known as spongiform cardiomyopathy or left ventricular non-compaction (LVNC) is a phenotype of hypertrophic ventricular trabeculations and deep interventricular recesses. It has been hypothesized to result from arrest of normal myocardial compaction dur...
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Normal chest imaging examples

This article lists examples of normal imaging of the chest and surrounding structures, divided by modality. Plain radiographs Adult examples chest radiograph PA adult male example 1 example 2: with inverted windows example 3 PA adult female example 1 example 2 example 3: with labels ...
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Normal contours of the cardiomediastinum on chest radiography

A detailed understanding of the structures that make up the normal contours of the heart and mediastinum (cardiomediastinal contour) on chest radiography is essential if abnormalities are to be detected.  Frontal view (PA/AP) Right cardiomediastinal contour From superior to inferior: right p...
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Normal pulmonary venous Doppler

Normal pulmonary venous blood flow in the pulmonary veins may be investigated during echocardiography with spectral Doppler analysis. Perturbations in the normal pulmonary venous waveform may indicate the presence of diastolic dysfunction and elevated filling pressures in the left atrium and ven...
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Norwood procedure

The Norwood procedure is a palliative procedure that is the first of three stages in the surgical treatment of hypoplastic left heart syndrome. The procedure consists of three components: constructing a neo-aorta by side-to-side anastomosis of the main pulmonary artery and ascending aorta, suc...
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Oblique pericardial sinus

The oblique pericardial sinus is a blind-ending pericardial cul-de-sac behind the heart which opens into the pericardial space proper inferiorly. Gross anatomy Its boundaries are: right (in ascending order): inferior vena cava, right inferior pulmonary vein and right superior pulmonary vein ...
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Obtuse marginal artery

The obtuse marginal (OM) arteries sometimes referred to as lateral branches are branch coronary arteries that come off the circumflex artery. There can be one or more obtuse marginal arteries. It typically traverses along the left margin of heart towards the apex. The first obtuse marginal arter...
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Ortner syndrome

Ortner syndrome, also known as cardiovocal syndrome, is characterized by hoarse voice resulting from left recurrent laryngeal nerve palsy secondary to a cardiovascular disorder. Pathology Left recurrent laryngeal nerve palsy in this condition is due to traction or compression of the nerve betw...
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Overall visual assessment of coronary artery calcification

Overall visual assessment of coronary artery calcification is a simple scoring system for risk assessment of coronary heart disease mortality by an overall "gestalt" of none, mild, moderate or heavy coronary artery calcification. It is comparable to the Agatston score but has the advantage of be...
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Pediatric cardiovascular procedures

A number of pediatric cardiovascular procedures are encountered when reporting pediatric imaging. They include: Blalock-Taussig (BT) shunt classic: end to side subclavian to ipsilateral pulmonary arterial anastomosis modified: graft anastomosis Waterston shunt Sano shunt: right ventricle to...
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Page kidney

Page kidney, or Page phenomenon, refers to systemic hypertension secondary to extrinsic compression of the kidney by a subcapsular collection, e.g. hematoma, seroma, or urinoma. Clinical presentation Patients present with hypertension, which may be recognized acutely after an inciting event or...
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Panzerherz (heart)

Panzerherz (or armoured heart) is a term used to describe the appearance of the heart in calcified constrictive pericarditis. The pericardium becomes circumferentially thickened with calcification, limiting the ability of the heart to contract. The rim of dense calcification describes how the h...
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Papillary fibroelastoma of the heart

Papillary fibroelastomas are rare benign primary cardiac tumors. However, of the primary cardiac tumors, they are one of the commonest to occur in relation to the cardiac valves (may account for 75% of valvular tumors 10).  Epidemiology Its estimated prevalence ranges between <0.01 to 0.33% 5....
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Papillary muscle calcification

Papillary muscle calcification in the heart small amounts can be a common finding in elderly patients and are often located at the apex. Large calcifications involving the papillary muscles are, however, rare. They have been associated with conditions such as: coronary artery disease dilated c...
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Papillary muscles

The papillary muscles are thick bands and ridges of endocardial-lined myocardium that project into the lumen of the cardiac ventricles. They essentially represent dominant ventricular trabeculae which attach to the cusps of the atrioventricular valves via the chordae tendineae. During systole, t...
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Parachute device

A parachute device or ventricular partitioning device is a percutaneously inserted cardiac device aimed at improving cardiac output and reducing cardiac remodeling in patients following myocardial infarction. Principle The device consists of an umbrella shaped frame with a overlying membrane, ...
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Parachute mitral valve

A parachute mitral valve is a valvular congenital abnormality usually identified in infants or young children, though it can present later, in adulthood. Pathology Parachute mitral valves occur when all the chordae tendineae are attached to a single papillary muscle origin. Unlike the normal s...
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Partial anomalous pulmonary venous return

Partial anomalous pulmonary venous return (PAPVR), also known as partial anomalous pulmonary venous connection (PAPVC), is a rare congenital cardiovascular condition in which some of the pulmonary veins, but not all, drain into the systemic circulation rather than in the left atrium. Clinical p...
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Passive hepatic congestion

Passive hepatic congestion, also known as congested liver in cardiac disease, describes the stasis of blood in the hepatic parenchyma, due to impaired hepatic venous drainage, which leads to the dilation of central hepatic veins and hepatomegaly.  Passive hepatic congestion is a well-studied re...
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Patent ductus arteriosus

Patent ductus arteriosus or arteriosum (PDA) is a congenital cardiac anomaly where there is persistent patency of the ductus arteriosus, a normal connection of the fetal circulation between the aorta and the pulmonary arterial system that develops from the 6th aortic arch. Epidemiology Patent ...
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Patent foramen ovale

A patent foramen ovale (PFO) is a type of atrial septal defect in which there is channel-like communication between the atria through an unfused fossa ovale. Gross anatomy The foramen ovale in the interatrial septum normally develops into the fossa ovalis when the flaps of the atrial septa pri...
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Pectinate muscles

The pectinate muscles are "teeth of a comb" shaped parallel muscular columns that are present on the inner wall of the right and left atria. The right atrium has thick and coarse pectinate muscles while these are few smooth and thinner in the left atrium. History and etymology The term is der...
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Pentalogy of Fallot

The pentalogy of Fallot is a variant of the more common tetralogy of Fallot, comprising the classic four features with the addition of an atrial septal defect or patent ductus arteriosus: ventricular septal defect (VSD)  right ventricular outlfow tract narrowing or complete obstruction right ...
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Pericardial agenesis

Pericardial agenesis is a rare condition where there is the absence of the pericardium to varying degrees. If it is only a small portion of the pericardium that is absent it is known as a pericardial defect. Epidemiology According to a surgical and pathological series, the prevalence (inclusiv...
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Pericardial cyst

Pericardial cysts are uncommon benign congenital anomalies of the anterior and middle mediastinum. Clinical presentation Usually asymptomatic and discovered incidentally although occasionally may present with chest pain and dyspnea. Pathology They are thought to often result from aberrations...
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Pericardial diverticulum

Pericardial diverticula are focal outpouching arising from the pericardium. They are differentiated from congenital pericardial cysts by the presence of direct communication with the pericardial cavity. They can change in size related to body position, with symptoms related to the change in posi...
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Pericardial effusion

Pericardial effusions occur when excess fluid collects in the pericardial space (a normal pericardial sac contains approximately 30-50 mL of fluid). Epidemiology There is no single demographic affected, as there are many underlying causes of pericardial effusion. Clinical presentation Clinic...
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Pericardial fat necrosis

Pericardial fat necrosis (a.k.a. epicardial fat necrosis) is a rare self-limiting cause of acute pleuritic pain in an otherwise healthy individual, without fever or cough. It occurs external to the pericardium. Clinical presentation The patient presents with an acute pleuritic chest pain that ...
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Pericardial fat pads

Pericardial fat pads are normal structures that lie in the cardiophrenic angle. They are adipose tissues surrounding the heart composed of the epicardial fat, which lies between the myocardium and visceral pericardium, and paracardial fat, which is adherent and external to the parietal pericardi...
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Pericardial hemangioma

Pericardial hemangioma is a location specific rare subtype of cardiac hemangioma which arises from either the parietal or visceral (commoner 3) pericardial layers.  Treatment and prognosis It is a benign tumor. Treatment option vary from monitoring to resection. See also pericardial tumors ...
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Pericardial ligaments

The pericardial ligaments is a name given to a group of variable fibrous ligaments or adhesions that connect the pericardium to adjacent structures. These ‘ligaments’ tether the fibrous pericardium to it's surrounds, hence movements of the chest wall and diaphragm  influence the position of the ...
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Pericardial lipoblastoma

Pericardial lipoblastomas are rare benign tumors that usually occur in children less than 3 years of age. They originate from embryonic fat cells and are divided into two forms, based on location 1: superficial form: well-circumscribed and well-encapsulated deep form: not well-circumscribed an...
Article

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...
Article

Pericardial mesothelioma

Pericardial mesothelioma refers to 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 p...
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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...
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Pericardial space

The pericardial space or cavity is the fluid-filled space 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 Pericardial effusion is the pathological accumula...
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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...
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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...
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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...
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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.
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Pericardiocentesis

Pericardiocentesis is a procedure that can be performed to withdraw pericardial fluid as a therapeutic intervention or a diagnostic modality. Indications diagnostic pericardial effusion of an unknown etiology therapeutic relief of pericardial tamponade Contraindications absolute none (gi...

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