Cardiac calcification is a broad term for any calcification affecting the valves, coronary arteries, aortic root, endocardium, myocardium, and/or pericardium.
Causes of cardiac calcification are:
coronary artery disease (most common)
coronary artery aneurysms, e.g. in Kawasaki dise...
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 aetiologies for cardiomegaly:
congestive heart failure
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...
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...
Delayed myocardial enhancement can occur in cardiac MR assessment due to a number of causes.
myocardial ischaemia: typically subendocardial and follows a vascular territory 1
non-ischaemic dilated cardiomyopathy
Dextrocardia is a congenital cardiac malrotation in which the heart is situated on the right side of the body (dextroversion) with the apex pointing to the right.
Dextrocardia merely refers to the laterality of the heart, it says nothing about the orientation of the patient's other...
A small cardiothoracic ratio (CTR) is defined as <42%/0.42 when assessed on a PA chest radiograph, and is often called small heart syndrome. A pathologically-small heart is also known as microcardia.It can be due to/associated with a number of entities:
adrenal insufficiency, e.g. Addison disea...
Drug and toxin induced pulmonary hypertension is one of the causes of pulmonary arterial hypertension. It falls under group 1.3 under the Dana point classification system of pulmonary hypertension.
A wide range of difference drugs have been associated with developing pulmonary hyper...
An enlarged/dilated azygos vein may result from a number of physiological as well as pathological causes. The enlarged azygos vein may be seen as a widened right paratracheal/paraspinal stripe on a frontal chest radiograph.
Spelling it "azygous" when referring to the vein is incorr...
The differential of an enlarged pulmonary trunk/main pulmonary artery on chest radiography includes:
may appear prominent in young patients especially women
rotation of the heart
left lower lobe collapse
pulmonary arterial hyp...
Fat containing cardiac lesions have a limited differential diagnosis. These include 1-4:
normal ageing/physiologic: mostly subepicardial, more in the right ventricle (especially right ventricular outflow tract) than left ventricle
lipomatous hypertrophy of the interatrial septum
Fetal cardiac tumours refer to primary cardiac tumours that can present in the in utero population.
Fetal cardiac tumours are rare; the prevalence, reported from autopsy studies of patients of all ages, varies from 0.0017-0.28 % 2.
Known cardiac tumour types that pres...
Haemopericardium refers to the presence of blood within the pericardial cavity, i.e. a sanguineous pericardial effusion. If enough blood enters the pericardial cavity, then a potentially fatal cardiac tamponade can occur.
There is a very long list of causes 1,4 but some o...
High output cardiac failure refers to a state of cardiac failure that is associated with a higher than normal cardiac output which is still not sufficient for body tissue demands.
Patients can present with a number of symptoms of varying degrees which include tachycardia,...
Cardiovascular manifestations are seen with increased frequency in the HIV/AIDS adult population, and include:
dilated cardiomyopathy (prevalence 8-30%)
endocarditis: either infective or non-bacterial thrombotic (marantic) which is associated with malignancy or HIV wasti...
Medical devices in the thorax are regularly observed by radiologists when reviewing radiographs and CTs.
tubing, clamps, syringes lying on or under the patient
rubber sheets, foam mattresses, clothing, hair braids, nipple piercings etc. may also be visible
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...
Mitral valve disease (MVD) mostly comprises two main functional abnormalities, which can occur in isolation or in combination:
In addition, other pathologies that affect the mitral valve include:
mitral valve prolapse
mitral annular calcification
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 revascularisation
to evaluate response to revascularisation
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...
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-...
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...
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.
Complication rates for median sternotomy have been reported to range from 0.5-5%, with mortality rate...
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 tumours 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. Tumours include 1-2:
most common in adults
accounts for ~50% of all primary be...
Primary malignant cardiac tumours are rare, and account for only ~25% of primary cardiac tumours, and only a small proportion of all malignant tumours which involve the heart: direct extension of adjacent tumours or metastatic deposits are far more common.
Histologcal types include 1...
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 visualised on imaging investigations. Sometimes the annulus...
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...
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.
As a group, RASopathies represent one of the most common malformation syndromes, with an in...
Restrictive cardiomyopathy is the least common subtype of cardiomyopathy and is characterised by a marked decrease in ventricular compliance.
Patients can present with symptoms and signs of left ventricular failure and/or right ventricular failure 9.
It is p...
Right atrial enlargement is less common, and harder to delineate on chest radiograph, than left atrial enlargement.
Enlargement of the right atrium can result from a number of conditions, including:
raised right ventricular pressures
pulmonary arterial hypertension
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.
Right heart strain can often occur as a re...
Thoracic manifestations of systemic lupus erythematosus can be variable.
For a general discussion, and for links to other system specific manifestations, please refer to the article on systemic lupus erythematosus.
pleuritis: considered one of the c...
Troponin is a protein of key importance in the functioning of skeletal and cardiac muscle. It forms part of the contractile mechanism, and comprises three main subunits: troponin C, troponin I, and troponin T.
Elevation of serum troponin can occur from a number of causes an...
The Valsalva manoeuvre is the forced expiration of air against a closed airway, resulting in increased intra-abdominal, intrathoracic and pharyngeal pressure. It can be performed against a closed glottis or by one closing the mouth and pinching the nose while forcibly exhaling.
It is commonly u...
Valvular heart diseases, or cardiac valvulopathies, describe any acquired or congenital disease affecting one or more of the four cardiac valves.
This is a general index article that classifies cardiac valvulopathies depending on which valve(s) is affected 1. See individual articles for in-dept...