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.

77 results found
Article

Atrio-oesophageal fistula

Atrial-oesophageal fistulas are rare pathological connections between the left atrium and the oesophagus.  Clinical presentation The presentation is non-specific. Patients may complain of fever, malaise, dysphagia or present with neurological symptoms 3.  Pathology The chief cause of atrial-...
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Bicuspid aortic valve

Bicuspid aortic valve (BAV) refers to a spectrum of deformed aortic valves with two functional leaflets or cusps which are often unequal in size. They are most often congenital while an acquired bicuspid valve occurs when there is fibrous fusion between the right and left cusps of a pre-existin...
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Carcinoid cardiac lesions

Carcinoid cardiac lesions are a known complication of carcinoid tumours and are particularly prevalent in those who develop the carcinoid syndrome (up to 50%). Pathology There is thickening of the mural and valvular endothelial surfaces of right-sided cardiac structures. This is thought to occ...
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Cardiac amyloidosis

Cardiac amyloidosis is a significant source of morbidity among patients with systemic amyloidosis, and is the most common cause of restrictive cardiomyopathy outside the tropics. Amyloidosis represents the extra-cellular deposition of insoluble fibrillar proteinaceous material in various organs...
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Cardiac fibroma

Cardiac fibroma, also known as cardiac fibromatosis, are benign congenital cardiac tumours that usually manifest in children.  Epidemiology Cardiac fibroma is a tumour that primarily affects children (most cases is detected in infants or in utero). They are the second most common benign primar...
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Cardiac lymphoma

Cardiac lymphoma is a rare tumour of the myocardium and/or pericardium. It may be considered as primary or secondary. Epidemiology Primary cardiac lymphoma is a rare occurrence, representing only 10% of primary malignant cardiac tumours (1% of all primary cardiac tumours). Secondary involveme...
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Cardiac myxoma

Cardiac myxomas, although uncommon are one of commonest primary cardiac tumours and account for ~50% primary benign cardiac tumours.  Epidemiology Cardiac myxomas are the most common primary cardiac tumour in adults but are relatively infrequent in childhood, where cardiac rhabdomyomas are mor...
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Cardiac rhabdomyoma

Cardiac rhabdomyomas are a type of benign myocardial tumour and are considered the most common fetal cardiac tumour. They have a strong association with tuberous sclerosis. Epidemiology Cardiac rhabdomyomas are often multiple and can represent up to 90% of cardiac tumours in the paediatric pop...
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Cardiac sclerosis

Cardiac sclerosis, or "cardiac cirrhosis" is the end-point of passive hepatic congestion from heart failure.  Pathology Aetiology Causes of cardiac cirrhosis include 1: ischaemic heart disease: ~30% cardiomyopathy: ~25% valvular heart disease: ~25% restrictive lung disease: ~15% pericard...
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Cardiac tuberculosis

Cardiac tuberculosis refers to the rare infection of the cardiac musculature with Mycobacterium tuberculosis. Pathology Generally associated with and occurring as a complication of mediastinal and pulmonary tuberculosis. Pericardial and myocardial involvement is known. Endocardial spread may ...
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Cardiac venous malformations

Cardiac venous malformations (also known as cardiac haemangiomas) 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. Terminology It is important to note that according to newer ...
Article

Cervical aortic arch

Cervical aortic arch is a rare aortic arch anomaly characterised by an elongated, high-lying aortic arch extending at or above the level of the medial ends of the clavicles. Clinical presentation Patients with cervical aortic arch are usually asymptomatic. Symptomatic patients may present with...
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Chagas disease

Chagas disease, also referred as trypanosomiasis, 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. Epidemiology Chagas disease is endemic to Central and South America....
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Congenitally corrected transposition of the great arteries

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. Epidemiology This anomaly comprises less than 1% of all congenital heart diseases 1,2,7.  Clin...
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Constrictive pericarditis

Constrictive pericarditis (or perhaps better termed pericardial constriction) is a type of pericarditis which leads to diastolic dysfunction and potentially symptoms of right heart failure.  Epidemiology No single demographic is affected as there are numerous causes of constrictive pericarditi...
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Cor pulmonale

Cor pulmonale is defined as an 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 ...
Article

Coronary arterial ectasia

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). Terminology It is often defined as dilatation of an arterial segment to a...
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Coronary artery aneurysm

Coronary artery aneurysms (CAA's) are an uncommon, predominantly incidental finding. Epidemiology CAA is 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. Clinical presentation Most c...
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Coronary artery disease

Coronary artery disease (CAD) is the leading cause of mortality globally.  Clinical presentation CAD is asymptomatic in most of the population. When severe enough it can cause angina, or an acute coronary syndrome including myocardial infarction. CAD may also present with heart failure or sudd...
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Coronary microvascular obstruction

Microvascular obstruction (MVO), also known as no reflow phenomenon, is an established complication encountered in coronary angioplasty for prolonged acute myocardial infarction.  Pathology The phenomenon results from obstruction of the myocardial microcirculation, which is composed of vessel...
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Determination of atrial situs

Atrial situs refers to the relative position of cardiac atria in relation to abdominal viscera and the midline. Pathology Identification of atrial situs is an important initial step in the antenatal and postnatal diagnosis of cardiac structural and situs anomalies. Radiographic features Basi...
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Double outlet right ventricle

Double outlet right ventricle (DORV) is a congenital cardiac anomaly where both the aorta and pulmonary trunk arise from the morphologically right ventricle. It is reported to account for ~2% of congenital cardiac defects 1. It is usually classed as a conotruncal anomaly. There is almost always ...
Article

Ebstein anomaly

Ebstein anomaly is an uncommon congenital cardiac anomaly, characterised by a variable developmental anomaly of the tricuspid valve. Epidemiology The anomaly accounts for only ~0.5% of congenital cardiac defects 6-7, although it is the most common cause of congenital tricuspid regurgitation. T...
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Ectopia cordis

Ectopia cordis is an extremely rare congenital malformation where the heart is located partially or totally outside the thoracic cavity. The four main ectopic positions are:: adjacent to the thorax: ~60 % abdominal: 15-30% thoraco-abdominal: 7-18%  cervical: ~3% Epidemiology The estimated ...
Article

Endocardial fibroelastosis

Endocardial fibroelastosis (EFE) is a rare cardiac condition which is classically described in the paediatric population (typically first two years). It is one of the causes for infants to present with unexplained heart failure.  Pathology The condition results from increasing amounts of fibro...
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Fetal atrial flutter

Fetal atrial flutter is the second most common fetal tachyarrhythmia and can account for up to 30% of such cases 1-2.  Clinical presentation As with other tachyarrthymias it is often detected in the 3rd trimester. Pathophysiology It has a typical atrial rate of 300-600 beats per minute (bpm)...
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Fetal bradyarrhythmia

Fetal bradyarrhythmia refers to an abnormally low fetal heart rate (less than 100-110 beats per minute 3,7) as well as being irregular, i.e. irregular fetal bradycardia. Pathology A fetal bradyarrhythmia can fall in to several types which include fetal partial atrioventricular block (PAVB) f...
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Fetal bradycardia

Fetal bradycardia refers to an abnormally low fetal heart rate, a potentially ominous finding. A sustained first trimester heart rate below 100 beats per minute (bpm) is generally considered bradycardic. The average fetal heart rate changes during pregnancy, however, and some consider the lower ...
Article

Fetal cardiomegaly

Fetal cardiomegaly (FC) essentially refers to an enlarged fetal heart. It is variably defined with some sources stating the cut off as a fetal cardio-thoracic circumference above two standard deviations 7.  Pathology It can arise from a number of situations which include congenital cardiac an...
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Fetal cardiomyopathy

Fetal cardiomyopathy refers to a very rare situation where a cardiomyopathy occurs in utero. It is often a diagnosis of exclusion where by definition there is an absence of an underlying congenital cardiac morphological anomaly. Epidemiology The estimated incidence is variable with the high en...
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Fetal pericardial teratoma

Fetal pericardial teratomas are rare pericardial teratomas that present in utero. They are an uncommon primary cardiac tumour occurring in a fetus. Pathology It is a type of germ cell tumour and arises from multipotential cells derived from all three germinal layers. In contrast to ovarian ter...
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Haemochromatosis (cardiac manifestations)

Cardiac involvement in haemochromatosis typically occurs with primary haemochromatosis, as the organ is usually spared in the secondary form of the disease. Epidemiology Cardiac involvement occurs in approximately 15-20% of the patients with haemochromatosis.  Clinical presentation Manifesta...
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Haemopericardium

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.  Pathology Aetiology There is a very long list of causes 1,4 but some o...
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Idiopathic dilated cardiomyopathy

Idiopathic dilated cardiomyopathy is a subtype of dilated cardiomyopathy. It is a type of non ischaemic cardiomyopathy where no underlying cause can be found. Epidemiology This form of cardiomyopathy may account for up to 50% of all dilated cardiomyopathies 4. Patients usually ranging around 2...
Article

Infective endocarditis

Infective endocarditis is defined as infection of the endocardium. It commonly affects the valve leaflets and chordae tendineae, as well as prosthetic valves and implanted devices. Epidemiology Infective endocarditis has an estimated general prevalence of 3 to 9 cases per 100,000 persons. Intr...
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Inter-arterial course of the left coronary artery

The inter-arterial course of the left coronary artery, also known as the malignant course of the left coronary artery, is defined as the origin of the left main or left anterior descending coronary artery from the right coronary sinus of Valsalva with a course between the ascending aorta and the...
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Interatrial septal aneurysm

Interatrial septal aneurysm or atrial septal aneurysm (ASA) is defined as an abnormal protrusion of the interatrial septum. The exact length of the protrusion that defines an interatrial septal aneurysm varies in the literature, ranging from >11 mm to >15 mm beyond normal excursion in adults 4-5...
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Kawasaki disease

Kawasaki disease (KD) is a small to medium vessel vasculitis predominantly affecting young children. It can affect any body organ but there is a predilection for the coronary vessels. Pathology An autoimmune aetiology has been postulated. It is generally self limiting but acute fatalities are ...
Article

Left ventricular aneurysm

Left ventricular aneurysms are discrete, dyskinetic areas of the left ventricular (LV) wall with a broad neck (as opposed to left ventricular pseudoaneurysms), thus often termed true aneurysms. Epidemiology True LV aneurysms develop in less than 5% of all patients with ST-elevation myocardial ...
Article

Left ventricular pseudoaneurysm

Left ventricular pseudoaneurysms are false aneurysms that result from contained myocardial rupture, and are a rare complication of a myocardial infarction (MI). They should not be confused with left ventricular aneurysms, which are true aneurysms containing all the layers (endocardium, myocardiu...
Article

Lipomatous hypertrophy of the inter-atrial septum

Lipomatous hypertrophy of the interatrial septum (LHIS) is a relatively uncommon disorder of the heart characterised by benign fatty infiltration of the interatrial septum. It is commonly found in elderly and obese patients as an asymptomatic incidentally discovered finding.  Epidemiology The ...
Article

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 centres on chronic infection with some author doubting its existence 3. There are some terms that help dif...
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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...
Article

Mitral valve regurgitation

Mitral valve regurgitation is due to functional or anatomical dysfunction of the mitral valve and can lead to striking chest x-ray abnormalities. Epidemiology The causes of mitral regurgitation are protean and, as such, there is no single group of patients who are affected. Mitral regurgitatio...
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Myocardial infarction

Myocardial infarction (MI), an acute coronary syndrome, results from interruption of myocardial blood flow and resultant ischaemia, and are a leading cause of death worldwide.  Epidemiology Risk factors male > females age > 45 for males > 55 for females cardiovascular risk factors: smokin...
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Myocarditis

Myocarditis 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 symptom, including fever and malaise. It typically oc...
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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 bacteraemia. The condition is seen in patients with advanced stage malignancies, and is related to episodes o...
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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...
Article

Passive hepatic congestion

Passive hepatic congestion or congested liver in cardiac disease is the stasis of blood in the hepatic parenchyma, due to impaired hepatic venous drainage which leads to widening and splaying of the central hepatic veins and hepatomegaly.  Passive hepatic congestion is a well-studied result of ...
Article

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 PDAs oc...
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Peri-partum/post-partum cardiomyopathy

Peri-partum/post-partum cardiomyopathy is a dilated cardiomyopathy that may occur in the last trimester of pregnancy through the first several months post-partum. Pathology The pathogenesis of post-partum cardiomyopathy is uncertain, with genetic factors, sympathetic tone, hormones, and malnut...
Article

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 portions of the pericardium that is absent it is known as a pericardial defect. Epidemiology According to a surgical and pathological series, the prevalence (inclusi...
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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 a pericardial effusion. Clinical presentation Clin...
Article

Pericardial lipoblastoma

Pericardial lipoblastomas are rare benign tumours that usually occur in children less than 3 years of age. The 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...
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Pericardial lipoma

Pericardial lipomas are slowly growing benign tumours 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 attenuat...
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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 o...
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Pseudocoarctation of the aorta

Pseudocoarctation of the aorta is a very rare anomaly characterised 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 characterised by elongation and ki...
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Pulmonary artery atresia

Pulmonary artery atresia (or sometimes known as pulmonary atresia) is one of 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. Patholog...
Article

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...
Article

Pulmonary vein stenosis

Pulmonary vein stenosis refers to a spectrum of condition characterised by narrowing to 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 identifiable...
Article

Raghib syndrome

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

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 An increased prevalence in females have been ...
Article

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 RA has an overall prevalence of 0.5-1%. There is a female predominance, with the disease being 2-3 times more c...
Article

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...
Article

Sarcoidosis (cardiac manifestations)

Cardiac manifestations of sarcoidosis are present in up to 25% of patients with sarcoidosis, but only 5-10% of patients are symptomatic 1-2. Sarcoidosis is a multisystem disorder characterised by the presence of non-caseating granulomas. For a general discussion of this condition please refer t...
Article

Sinus of Valsalva aneurysm

Sinus of Valsalva aneurysms are a cause of thoracic aortic dilatation. They can be either congenital or acquired (mycotic). Epidemiology There is a male predilection (M:F ratio being around 3-4:1). They are relatively more common in eastern and Asian populations and can occur in any age group ...
Article

Stunned myocardium

Stunned myocardium refers to a situation in which an acute transient myocardial ischemic event results in a prolonged wall motion abnormality which eventually resolves. The term is usually distinguished from "hibernating" myocardium, in which a chronic ischaemic process leads to chronic left ve...
Article

Takotsubo cardiomyopathy

Takotsubo cardiomyopathy (TC) is a condition which has been described predominantly in postmenopausal women following exposure to sudden, unexpected emotional or physical stress.  Pathology There is a transient left ventricular dysfunction and there is no evidence of obstructive epicardial cor...
Article

Taussig-Bing anomaly

Taussig-Bing anomaly is a rare congenital heart malformation and is one of the variants of double outlet right ventricle. It consists of transposition of the aorta to the right ventricle and malposition of the pulmonary artery with subpulmonary ventricular septal defect. History and etymology ...
Article

Tetralogy of Fallot

Tetralogy of Fallot (TOF) is the second most common cyanotic congenital heart condition and has been classically characterised by the combination of ventricular septal defect (VSD), right ventricular outflow tract obstruction (RVOTO), overriding aorta, and a late right ventricular hypertrophy. ...
Article

Total anomalous pulmonary venous return

Total anomalous pulmonary venous return (TAPVR) is a cyanotic congenital heart anomaly with an abnormal drainage anatomy of the entire pulmonary venous system. This contrasts with partial anomalous pulmonary venous return (PAPVR) where only part of the pulmonary venous anatomy is abnormal. In T...
Article

Transposition of the great arteries

Transposition of the great arteries (TGA) is the most common cyanotic congenital cardiac anomaly with cyanosis in the first 24 hours of life. It accounts for up to 7% of all congenital cardiac anomalies 1  and can be assessed with echocardiography, gated cardiac CT, or cardiac MRI. Epidemiology...
Article

Tricuspid stenosis

Tricuspid stenosis (TS) refers to narrowing of the tricuspid valve. It is an uncommon condition and is different to tricuspid hypoplasia where in the latter, the right ventricle also often tends to be hypoplastic. Pathology Tricuspid stenosis most commonly occurs in the setting of rheumatic he...
Article

Truncus arteriosus

Truncus arteriosus is a cyanotic congenital heart anomaly in which a single trunk supplies both the pulmonary and systemic circulation, instead of a separate aorta and a pulmonary trunk. It is usually classified as a conotruncal anomaly. It accounts for up to 2% of congenital cardiac anomalies ...
Article

Uhl anomaly

Uhl anomaly is an unusual cardiac disorder which affects the right ventricle where there is almost complete absence of right ventricular myocardium, normal tricuspid valve, and preserved septal and left ventricular myocardium. History and etymology It is named after Henry S D Uhl, who first de...
Article

Unilateral pulmonary vein atresia

Unilateral pulmonary vein atresia is a type of pulmonary vein atresia. Pathology It results from failure of incorporation of the common pulmonary vein into the left atrium. There is no recognised right or left predilection. Clinical presentation The condition usually present in infancy or ch...
Article

Ventricular septal defect

Ventricular septal defects (VSD) represent defects in the interventricular septum that allow a haemodynamic communication between the right and left ventricles. It typically results in a left-to-right shunt. Epidemiology They represent one of the most common congenital cardiac anomalies and ma...

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