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Radiographic Pathology for Radiographic Pathology for Technologists, 5Technologists, 5thth Edition Edition
Chapter 8Chapter 8
Cardiovascular SystemCardiovascular System
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Anatomy and PhysiologyAnatomy and Physiology
Consists of:Consists of: HeartHeart
ArteriesArteries
CapillariesCapillaries
VeinsVeins
Pulmonary circulationPulmonary circulation
Systemic circulationSystemic circulation
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Anatomy and PhysiologyAnatomy and Physiology
HeartHeart LocationLocation
AtriaAtria
VentriclesVentricles
LayersLayers EndocardiumEndocardium
MyocardiumMyocardium
EpicardiumEpicardium
Blood travelBlood travel
Gas exchangeGas exchange
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Anatomy and PhysiologyAnatomy and Physiology
Cardiac cycleCardiac cycle SystoleSystole
DiastoleDiastole
SA nodeSA node
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Anatomy and PhysiologyAnatomy and Physiology
ElectrocardiographyElectrocardiography P waveP wave
PR intervalPR interval
QRS complexQRS complex
T waveT wave
QT durationQT duration
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Anatomy and PhysiologyAnatomy and Physiology
Circulatory vesselsCirculatory vessels ArteriesArteries
• AdventitiaAdventitia
• MediaMedia
• Intima and lumenIntima and lumen
VeinsVeins
CapillariesCapillaries
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Imaging ConsiderationsImaging Considerations
Chest radiographyChest radiography Heart sizeHeart size
CardiomegalyCardiomegaly
Great vessels Great vessels
Vascular lung markingsVascular lung markings PneumothoraxPneumothorax
Pulmonary emphysemaPulmonary emphysema
Bony thoraxBony thorax ScoliosisScoliosis
Pectus excavatumPectus excavatum
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Imaging ConsiderationsImaging Considerations
Chest radiographyChest radiography Technical factorsTechnical factors
• Patient positioningPatient positioning
• Technical factorsTechnical factors
• Geometric factorsGeometric factors
• Patient factorsPatient factors
• Image critiqueImage critique
One of most commonly performed radiographic One of most commonly performed radiographic proceduresprocedures
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9 Imaging Considerations & AnatomyImaging Considerations & Anatomy
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10 Imaging ConsiderationsImaging Considerations EchocardiographyEchocardiography M-mode echocardiographyM-mode echocardiography 2-D echocardiography2-D echocardiography
• Real-time imagingReal-time imaging
• Transesophageal echocardiography (TEE)Transesophageal echocardiography (TEE)
Spectral DopplerSpectral Doppler Color DopplerColor Doppler
• Carotid stenosis, DVTCarotid stenosis, DVT
Stress echocardiographyStress echocardiography
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Imaging ConsiderationsImaging Considerations
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Imaging ConsiderationsImaging Considerations
Nuclear cardiologyNuclear cardiology Used to diagnose CAD, congenital heart disease, Used to diagnose CAD, congenital heart disease,
and cardiomyopathyand cardiomyopathy
Myocardial perfusion scanMyocardial perfusion scan• Most widely used procedureMost widely used procedure
Gated cardiac blood pool scansGated cardiac blood pool scans• Used to evaluate ventriclesUsed to evaluate ventricles
Positron emission tomography (PET)Positron emission tomography (PET)
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Imaging ConsiderationsImaging Considerations
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Imaging ConsiderationsImaging Considerations
Computed tomography (CT)Computed tomography (CT)
Cardiac scoringCardiac scoring
EBCTEBCT
Spiral CTSpiral CT
CT angiography (CTA)CT angiography (CTA)
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Imaging ConsiderationsImaging Considerations
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Imaging ConsiderationsImaging Considerations
Magnetic resonance imaging (MRI)Magnetic resonance imaging (MRI) Recently gained in popularity for use in cardiac Recently gained in popularity for use in cardiac
studiesstudies
Uses cine loopUses cine loop
May be ECG gatedMay be ECG gated
Magnetic resonance angiography (MRA)Magnetic resonance angiography (MRA)
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Imaging ConsiderationsImaging Considerations
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Imaging ConsiderationsImaging Considerations
AngiographyAngiography Most commonly Most commonly
performed performed procedure for procedure for cardiovascular cardiovascular diseasedisease
Diagnostic vs Diagnostic vs therapeutictherapeutic
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Imaging ConsiderationsImaging Considerations
Therapeutic angiographyTherapeutic angiography Percutaneous transluminal coronary angioplasty Percutaneous transluminal coronary angioplasty
(PTCA)(PTCA) StentStent
ThrombolysisThrombolysis
EmbolizationEmbolization
Transjugular intrahepatic portosystemic stent Transjugular intrahepatic portosystemic stent (TIPSS)(TIPSS)
Percutaneous transluminal angioplastyPercutaneous transluminal angioplasty
Permanent catheterizationPermanent catheterization
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Imaging ConsiderationsImaging Considerations
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
Fetal circulatory systemFetal circulatory system• Foramen ovaleForamen ovale
• Ductus arteriosusDuctus arteriosus
Incidence of congenital cardiovascular anomaliesIncidence of congenital cardiovascular anomalies
EtiologyEtiology
• Genetic disordersGenetic disorders
• Chromosomal aberrationsChromosomal aberrations
• Environmental factorsEnvironmental factors
Associated complicationsAssociated complications
• MurmurMurmur
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
Patent ductus arteriosusPatent ductus arteriosus IncidenceIncidence
DiagnosisDiagnosis
• EchocardiographyEchocardiography
TreatmentTreatment
PrognosisPrognosis
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
Coarctation of Coarctation of the aortathe aorta IncidenceIncidence
DiagnosisDiagnosis
Radiographic Radiographic appearanceappearance
TreatmentTreatment
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
Septal defectsSeptal defects Atrial septal defectAtrial septal defect
Ventricular septal defectVentricular septal defect CauseCause
IncidenceIncidence
DiagnosisDiagnosis
Radiographic appearanceRadiographic appearance
Associated complicationsAssociated complications
TreatmentTreatment
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
Transposition of the great vesselsTransposition of the great vessels IncidenceIncidence
DiagnosisDiagnosis
Radiographic appearanceRadiographic appearance
TreatmentTreatment
PrognosisPrognosis
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
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Congenital and Hereditary DiseasesCongenital and Hereditary Diseases
Tetralogy of FallotTetralogy of Fallot Combination of Combination of
four defectsfour defects
DiagnosisDiagnosis
Radiographic Radiographic appearanceappearance
TreatmentTreatment
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Valvular DiseasesValvular Diseases
SymptomsSymptoms
Associated clinical findingsAssociated clinical findings
DiagnosisDiagnosis NoninvasiveNoninvasive
InvasiveInvasive
Cause of chronic valve diseaseCause of chronic valve disease Rheumatic feverRheumatic fever
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Valvular DiseasesValvular Diseases
Valvular stenosisValvular stenosis CauseCause Mitral valve Mitral valve
prolapseprolapse IncidenceIncidence DiagnosisDiagnosis Radiographic Radiographic appearanceappearance ProphylaxisProphylaxis TreatmentTreatment
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Valvular DiseasesValvular Diseases
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Congestive Heart FailureCongestive Heart Failure
OccurrenceOccurrence
TreatmentTreatment
Left-sided CHFLeft-sided CHF CausesCauses
SymptomsSymptoms
Radiographic appearanceRadiographic appearance
Right-sided CHFRight-sided CHF CausesCauses
SymptomsSymptoms
Radiographic appearanceRadiographic appearance
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Congestive Heart FailureCongestive Heart Failure
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Cor PulmonaleCor Pulmonale
CauseCause
Acute Acute Pulmonary embolismPulmonary embolism
ChronicChronic COPDCOPD
SymptomsSymptoms
DiagnosisDiagnosis
Radiographic appearanceRadiographic appearance
TreatmentTreatment
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Degenerative DiseasesDegenerative Diseases
AtherosclerosisAtherosclerosis Most prevalent disease in humansMost prevalent disease in humans
IncidenceIncidence
Predilection for aorta, coronary, and cerebral Predilection for aorta, coronary, and cerebral arteriesarteries
Risk factorsRisk factors
• Controlled Controlled
• UncontrolledUncontrolled
Atheroma formationsAtheroma formations
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Degenerative DiseasesDegenerative Diseases
AtherosclerosisAtherosclerosis Formation of Formation of
atheromaatheroma
• Chronic Chronic endothelial endothelial injuryinjury
• Lipid theoryLipid theory
IschemiaIschemia Signs and Signs and
symptomssymptoms DiagnosisDiagnosis Most common Most common
cause of CAD cause of CAD and CVAand CVA
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Degenerative DiseasesDegenerative Diseases
Coronary artery diseaseCoronary artery disease CauseCause
InfarctInfarct
Associated complicationsAssociated complications
• Angina pectorisAngina pectoris
Single most common cause of death in men and Single most common cause of death in men and women in U.S.women in U.S.
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Degenerative DiseasesDegenerative Diseases
Coronary artery diseaseCoronary artery disease
Risk factorsRisk factors
DiagnosisDiagnosis
TreatmentTreatment
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Degenerative DiseasesDegenerative Diseases
Myocardial infarction (MI)Myocardial infarction (MI) CauseCause
• Most common—acute thrombus of coronary arteryMost common—acute thrombus of coronary artery
Signs and symptomsSigns and symptoms
Early medical interventionEarly medical intervention
DiagnosisDiagnosis
TreatmentTreatment
• Thrombolytic therapyThrombolytic therapy
• PCTAPCTA
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AneurysmsAneurysms
Outpouching of vessel wallOutpouching of vessel wall
CausesCauses
ClassificationsClassifications SaccularSaccular
• Cerebral arteryCerebral artery
FusiformFusiform
• Distal abdominal aortaDistal abdominal aorta
DissectingDissecting
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AneurysmsAneurysms
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AneurysmsAneurysms
Abdominal aortic Abdominal aortic aneurysmaneurysm Majority of Majority of
aneurysms aneurysms
DiagnosisDiagnosis
TreatmentTreatment
• Surgical repair if Surgical repair if greater than 6 cmgreater than 6 cm
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AneurysmsAneurysms
Thoracic Thoracic aortic aortic aneurysmaneurysm Cause Cause
DiagnosisDiagnosis
TreatmentTreatment
• Surgical Surgical repair if repair if greater greater than 6 than 6 cmcm
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AneurysmsAneurysms
ExtremitiesExtremities Popliteal arteriesPopliteal arteries
• BilateralBilateral
• In conjunction with AAAIn conjunction with AAA
• DiagnosisDiagnosis
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Venous ThrombosisVenous Thrombosis
CauseCause
IncidenceIncidence
PhlebitisPhlebitis
ThrombusThrombus
ThrombophlebitisThrombophlebitis
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Venous ThrombosisVenous Thrombosis
DiagnosisDiagnosis SonographySonography
VenographyVenography
TreatmentTreatment
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Venous ThrombosisVenous Thrombosis
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Pathology SummaryPathology Summary
Additive Additive
Coarctation of aortaCoarctation of aorta
Septal defectsSeptal defects
Tetralogy of FallotTetralogy of Fallot
Valvular diseaseValvular disease
Congestive heart diseaseCongestive heart disease
Cor pulmonaleCor pulmonale
