Radiographic Pathology for Technologists, 5 th Edition

1. Radiographic Pathology for Technologists, 5th Edition Chapter 8 Cardiovascular System

2. Anatomy and Physiology • Consists of: • Heart • Arteries • Capillaries • Veins • Pulmonary circulation • Systemic circulation

3. Anatomy and Physiology • Heart • Location • Atria • Ventricles • Layers • Endocardium • Myocardium • Epicardium • Blood travel • Gas exchange

4. Anatomy and Physiology • Cardiac cycle • Systole • Diastole • SA node

5. Anatomy and Physiology • Electrocardiography • P wave • PR interval • QRS complex • T wave • QT duration

6. Anatomy and Physiology • Circulatory vessels • Arteries • Adventitia • Media • Intima and lumen • Veins • Capillaries

7. Imaging Considerations • Chest radiography • Heart size • Cardiomegaly • Great vessels • Vascular lung markings • Pneumothorax • Pulmonary emphysema • Bony thorax • Scoliosis • Pectus excavatum

8. Imaging Considerations • Chest radiography • Technical factors • Patient positioning • Technical factors • Geometric factors • Patient factors • Image critique • One of most commonly performed radiographic procedures

9. Imaging Considerations & Anatomy

10. Imaging Considerations • Echocardiography • M-mode echocardiography • 2-D echocardiography • Real-time imaging • Transesophageal echocardiography (TEE) • Spectral Doppler • Color Doppler • Carotid stenosis, DVT • Stress echocardiography

11. Imaging Considerations

12. Imaging Considerations • Nuclear cardiology • Used to diagnose CAD, congenital heart disease, and cardiomyopathy • Myocardial perfusion scan • Most widely used procedure • Gated cardiac blood pool scans • Used to evaluate ventricles • Positron emission tomography (PET)

13. Imaging Considerations

14. Imaging Considerations • Computed tomography (CT) • Cardiac scoring • EBCT • Spiral CT • CT angiography (CTA)

15. Imaging Considerations

16. Imaging Considerations • Magnetic resonance imaging (MRI) • Recently gained in popularity for use in cardiac studies • Uses cine loop • May be ECG gated • Magnetic resonance angiography (MRA)

17. Imaging Considerations

18. Imaging Considerations • Angiography • Most commonly performed procedure for cardiovascular disease • Diagnostic vs therapeutic

19. Imaging Considerations • Therapeutic angiography • Percutaneous transluminal coronary angioplasty (PTCA) • Stent • Thrombolysis • Embolization • Transjugular intrahepatic portosystemic stent (TIPSS) • Percutaneous transluminal angioplasty • Permanent catheterization

20. Imaging Considerations

21. Congenital and Hereditary Diseases • Fetal circulatory system • Foramen ovale • Ductus arteriosus • Incidence of congenital cardiovascular anomalies • Etiology • Genetic disorders • Chromosomal aberrations • Environmental factors • Associated complications • Murmur

22. Congenital and Hereditary Diseases • Patent ductus arteriosus • Incidence • Diagnosis • Echocardiography • Treatment • Prognosis

23. Congenital and Hereditary Diseases

24. Congenital and Hereditary Diseases • Coarctation of the aorta • Incidence • Diagnosis • Radiographic appearance • Treatment

25. Congenital and Hereditary Diseases

26. Congenital and Hereditary Diseases • Septal defects • Atrial septal defect • Ventricular septal defect • Cause • Incidence • Diagnosis • Radiographic appearance • Associated complications • Treatment

27. Congenital and Hereditary Diseases

28. Congenital and Hereditary Diseases • Transposition of the great vessels • Incidence • Diagnosis • Radiographic appearance • Treatment • Prognosis

29. Congenital and Hereditary Diseases

30. Congenital and Hereditary Diseases • Tetralogy of Fallot • Combination of four defects • Diagnosis • Radiographic appearance • Treatment

31. Valvular Diseases • Symptoms • Associated clinical findings • Diagnosis • Noninvasive • Invasive • Cause of chronic valve disease • Rheumatic fever

32. Valvular Diseases • Valvular stenosis • Cause • Mitral valve prolapse • Incidence • Diagnosis • Radiographic • appearance • Prophylaxis • Treatment

33. Valvular Diseases

34. Congestive Heart Failure • Occurrence • Treatment • Left-sided CHF • Causes • Symptoms • Radiographic appearance • Right-sided CHF • Causes • Symptoms • Radiographic appearance

35. Congestive Heart Failure

36. Cor Pulmonale • Cause • Acute • Pulmonary embolism • Chronic • COPD • Symptoms • Diagnosis • Radiographic appearance • Treatment

37. Degenerative Diseases • Atherosclerosis • Most prevalent disease in humans • Incidence • Predilection for aorta, coronary, and cerebral arteries • Risk factors • Controlled • Uncontrolled • Atheroma formations

38. Degenerative Diseases • Atherosclerosis • Formation of atheroma • Chronic endothelial injury • Lipid theory • Ischemia • Signs and symptoms • Diagnosis • Most common cause of CAD and CVA

39. Degenerative Diseases • Coronary artery disease • Cause • Infarct • Associated complications • Angina pectoris • Single most common cause of death in men and women in U.S.

40. Degenerative Diseases • Coronary artery disease • Risk factors • Diagnosis • Treatment

41. Degenerative Diseases • Myocardial infarction (MI) • Cause • Most common—acute thrombus of coronary artery • Signs and symptoms • Early medical intervention • Diagnosis • Treatment • Thrombolytic therapy • PCTA

42. Aneurysms • Outpouching of vessel wall • Causes • Classifications • Saccular • Cerebral artery • Fusiform • Distal abdominal aorta • Dissecting

43. Aneurysms

44. Aneurysms • Abdominal aortic aneurysm • Majority of aneurysms • Diagnosis • Treatment • Surgical repair if greater than 6 cm

45. Aneurysms • Thoracic aortic aneurysm • Cause • Diagnosis • Treatment • Surgical repair if greater than 6 cm

46. Aneurysms • Extremities • Popliteal arteries • Bilateral • In conjunction with AAA • Diagnosis

47. Venous Thrombosis • Cause • Incidence • Phlebitis • Thrombus • Thrombophlebitis

48. Venous Thrombosis • Diagnosis • Sonography • Venography • Treatment

49. Venous Thrombosis

50. Pathology Summary • Additive • Coarctation of aorta • Septal defects • Tetralogy of Fallot • Valvular disease • Congestive heart disease • Cor pulmonale