Pulmonary changes in cardiac diseases
- a. Venous HTN, upper lobe vessels are greater or equal to in size to lower lobe vessels = cephalisation
- b. Pulmonary hypervolemia, stasis and oedema
Pulmonary HT
- Causes of secondary pulmonary HTN include LHF, MS, COPD, fibrosis, pulmonary vein stenosis, chronic renal failure, kyphoscoliosis, hypoventilation syndrome
- Grade 1 = central and peripheral HTN
- Grade 2 = muscular HT, intimal thickening, adventitia thickening, focal proliferation of endothelium
- Grade 3 = interstitial oedema
- Grade 4 – alveolar oedema and interlobar effusion
AP view CT-angiography Shows rupture of the aortic intima. Blood will enter the aortic wall and form a haematoma. This will stratify the intima and media.
DX aortic dissection
Image 2 Lateral view of mediastinum CT Shows dissecting flap
Image 3 AP view of thoracic and abdominal cavity CT Shows formation of 2 lumens.
1st image Abdominal aortic aneurysm with thrombosis of the wall, the contrasted part is the real active lumen
2nd image CT-angio shows fusiform aneurysm in distal 3rd of abdominal aorta above the bifurcation
Image 3/4 Shows aneurysm in the left popliteal artery and shows parietal thrombosis
Image 5 Shows saccular aneurysm. Most commonly found in circle of willis (cerebral)
1st image CT-angio showing atherosclerosis of abdominal aorta uneven vascular lumen. Can see calcified plaques. And the left common iliac artery is obliterated
2nd image Shows right popliteal artery is obliterated with atherosclerotic plaques. Distal artery insufficiency Dx atherosclerosis
1st image Axial CT of mediastinum with contrast Shows thrombus in pulmonalis trunk and both of the pulmonary arteries. There is visible defect in the contrast filling of the vessels
2nd image Axial CT of mediastinum with contrast Shows thrombus in left pulmonary artery also has visible defect in contrast filling of vessel.
MRI-angio Adv- non invasive, no radiation, less chance of allergic reactions to contrast Dis- expensive, lengthy, limited availability
Substituted for CT angio when iodine contrast can’t be used Shows high quality blood vessels
CT-angio Adv-quick, cheap, no sedation, non-invasive Dis- high dose radiation and reactions to contrast