Purple Primer Cardiac Differential Diagnosis
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Complete list of Terms and Definitions for Purple Primer Cardiac Differential Diagnosis

Terms Definitions
Acquired heart disease Approach? Pressure overload: -Stenosis -HTN -Causes hypertrophy, normal heart size Volume overload: -Regurgitation -Shunt -Causes dilatation, large heart size Wall abnormalities
Pulmonary artery enlargement? Pulmonary artery HTN: -Primary pulmonary artery HTN -Secondary pulmonary artery HTN -PA stenosis (Williams, Rubella, Takayasu's, CHD) -PA dilatation (post-stenotic jet, Osler-Weber-Rendu) -Aneurysm cystic medial stenosis (Behcet's, Takayasu's)
Acquired heart disease T1 bright cardiac lesions? Benign: -Thrombus -Lipoma -Myxoma -Lipomatous hypertrophy of the interatrial septum Malignant (enhances): -Angiosarcoma
Congenital heart disease Skeletal abnormalities and heart disease? Rib notching: coarctation Hypersegmented manubrium, 11 paris of ribs: Down's Pectus excavatum: prolapsed MV, Marfan Multiple sternal ossification centers: cyanotic CHD Bulging sternum: large L to R shunt Scoliosis: Marfan, Tetralogy of Fallot
Pulmonary venous HTN LV dysfunction: -Ischemic heart disease -Valvular heart disease -CHD -Cardiomyopathy Left atrium: -Cor triatriatum -LA myxoma
Acquired heart disease Abnormal right heart contour? Pressure overload: -PA HTN -Pulmonic stenosis Volume overload: -Pulmonic or tricuspid regurgitation -Shunts: ASD, VSD -High-output states Wall abnormalities: -Aneurysm, infarct -Cardiomyopathy -Uhl's anomaly
Differential diagnosis of congenital heart disease by age of presentation? 0 to 2 days: hypoplastic left heart, aortic atresia, "5Ts" 7 to 14 days: coarctation, aortic stenosis, AVM, endocardial fibroelastosis Infants: VSD, PDA Adults: ASD
Pulmonary arterial HTN Classification? Pre-capillary Post-capillary
Cardiovascular calcifications Aorta? Atherosclerosis Syphilitic aortitis Aneurysm
Congenital heart disease Inferior rib notching? Aortic obstruction: -Coarctation -Interruption of aortic arch Subclavian artery obstruction: -Blalock-Taussig shunt (upper 2 ribs) -Takayasu's (unilateral) Severely reduced pulmonary blood flow: -Tetralogy of Fallot -Pulmonary atresia -Ebstein's SVC obstruction Vascular shunts (AVM of intercostals) Intercostal neuroma Osseous abnormality (Hyperparathyroidism)
Congenital heart disease Massive cardiomegaly in the newborn? Box-shaped right heart (RA enlarged): Ebstein's Uhl's Tricuspid atresia Herniation of liver into pericardial sac Massive pericardial effusion
Congenital heart disease with normal heart size and normal lungs? Coarctation Tetralogy of Fallot
Acquired heart disease Cardiac masses? Thrombus Lipoma Infectious vegetation Neoplasm: -Mets -Atrial myxoma -Rhabdomyoma -Pericardial cyst -Angiosarcoma
Right aortic arch and congenital heart disease? Truncus arteriosis Tetralogy of Fallot Transposition of great arteries Tricuspid atresia Pulmonary atresia with VSD Double outlet right ventricle Pseudotruncus Asplenia Pink tetralogy
Congenital heart disease Acyanotic heart disease Normal pulmonary vascularity? Aortic stenosis Coarctation Pulmonic stenosis
Pulmonary arterial HTN Pre-capillary HTN? Left to right shunts Chronic PE Vasculitis Drugs Idiopathic Emphysema Interstitial fibrosis Fibrothorax, chest wall deformities Alveolar hypoventilation
Acquired heart disease Abnormal left heart contour? Pressure overload: -Aortic or mitral stenosis -Systemic HTN -Coarctation Volume overload: -Mitral or aortic regurgitation -Shunts (ASD, VSD) -High-output states -End-stage heart failure Wall abnormalities: -Aneurysm, infarct -Cardiomyopathy
Congenital heart disease Cyanotic heart disease? Normal or decreased pulmonary vascularity: -Normal Heart Size (Tetralogy of Fallot, Fallot variants) -Cardiomegaly RA enlargment (Ebstein's, Tricuspid atresia, Pulmonic atresia)
Acquired heart disease Left atrial enlargement? Mitral regurgitation (LA and LV enlarged) Mitral stenosis (LA enlarged, LV normal) Rheumatic heart disease A fib Papillary muscle rupture (MI)
Acquired heart disease High-cardiac output states? Severe anemia Peripheral AVM Liver hemangioma Thyrotoxicosis Pregnancy
Acquired heart disease CHF? High output failure by age: -Premature: PDA - 1st week: Hypoplastic left heart syndrom -2nd week: coarctation -Infant: VSD - Adult: ASD Increased heart size with normal vascularity: -Pericardial effusion -Cardiomyopathy -Valvular disease
Cardiovascular calcifications Pericardial? Pericarditis Pericardial cysts
Congenital heart disease Superior rib notching? Abnormal osteoclastic activity: -Hyperparathyroidism -Idiopathic Abnormal osteoblastic activity: -Poliomyelitis -Collagen vascular disease -Local pressure -OI -Marfan
Congenital heart disease Acyanotic heart disease Increased pulmonary vascularity? (Left to Right Shunt) With LA enlargement: -VSD -PDA With normal LA: -ASD -ECD -PAPVC and sinus venous ASD
Eisenmenger's physiology? VSD ASD PDA Endocardial cushion defect
Pneumopericardium? Iatrogenic (aspiration, puncture) Cardiac surgery Barotrauma Fistula from bronchogenic or esophageal carcinoma
Acquired heart disease Small heart? Normal variant (deep inspiration) Addison's disease Anorexia/bulimia Dehydration Severe COPD
Pulmonary arterial HTN Post-capillary HTN? LV failure Mitral stenosis LA myxoma Idiopathic venocclusive disease Thrombus Tumor
Coronary aneurysm? Atherosclerotic Congenital Periarteritis nodosa Kawasaki disease Mycotic Syphilis Trauma
Congenital heart disease Pulmonary edema in newborns? Cardiac: Edema + large heart = hypoplastic RV or LV Edema + normal heart = TAPVC below diaphragm Transient tachypnea of newborn Pulmonary lymphangiectasia Pulmonary vein atresia Cor triatriatum Suprvalvular mitral ring Parachute mitral valve
Cardiovascular calcifications Intracardiac? Calcified valves Calcified thrombus Tumors
Congenital heart disease Boot-shaped heart? Tetralogy of Fallot Adults: -Loculated pleural effusion -Cardiac aneurysm -Pericardial cyst
Acquired heart disease Pericardial effusion? CHF Acute MI Post-surgical Autoimmune Renal failure Viral infection Pericardial mets
Congenital heart disease Increased pulmonary vascularity? the "5Ts:" Transposition of the great arteries Truncus arteriosis Total anomalous pulmonary venous connection Tricuspid atresia Tingle=single ventricle
Cardiovascular calcifications Myocardial? Coronary arteries Calcified infarct Aneurysm Postmyocarditis