Imaging

Atrial Septal Defect

Preliminary Diagnosis: Atrial Septal Defect

I. What imaging technique is first-line for this diagnosis

  • 2-D Echocardiography

II. Describe the advantages and disadvantages of this technique for diagnosis.

Advantages

  • Highly portable imaging modality.

  • Does not expose patients to ionizing radiation.

  • Highly sensitive and specific in detecting cardiac structural abnormalities and cardiac chamber pressures.

Disadvantages

  • Limited in evaluating the surrounding soft tissues.

III. What are the contraindications for the first-line imaging technique?

  • No specific contraindications to echocardiography exist

IV. What alternative imaging techniques are available?

  • Plain Radiography of the Chest (PA and Lateral)

  • Cardiac MR.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis.

Plain Radiography of the Chest (PA and Lateral)

Advantages

  • Fast and portable imaging modality.

  • Exposes patients to minimal ionizing radiation.

Disadvantages

  • Less sensitive and specific in detailing the cardiomediastinal silhouette, pericardium, and cardiac chambers.

  • Unable to evaluate the pressure measurements within the cardiac chambers and valvular structures.

Cardiac MR

Advantages

  • Sensitive and specific in detecting the flow and directionality of blood throughout the cardiac chambers and surrounding great vessels

  • Gold standard in evaluating cardiac structure including valvular and chamber architecture.

  • Does not expose patients to ionizing radiation.

Disadvantages

  • Expensive

  • Time consuming

  • Must be cardiac gated to eliminate cardiac motion artifact.

VI. What are the contraindications for the alternative imaging techniques?

Plain Radiography of the Chest (PA and Lateral)

  • No specific contraindications to plain radiography exist. Some insitutions may require signed consent for pregnant women

Cardiac MR

  • Contraindicated in patients with non MR compatible hardware.

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