Ebsteins anomaly of the tricuspid valve MRI: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(15 intermediate revisions by 4 users not shown)
Line 5: Line 5:
{{CMG}} and Claudia P. Hochberg, M.D. [mailto:chochber@bidmc.harvard.edu]
{{CMG}} and Claudia P. Hochberg, M.D. [mailto:chochber@bidmc.harvard.edu]


'''Associate Editor-In-Chief:''' {{CZ}}}; [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu] [[Priyamvada Singh|Priyamvada Singh, MBBS]] [[mailto:psingh@perfuse.org]] '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [[mailto:kfeeney@perfuse.org]]
'''Associate Editor-In-Chief:''' {{CZ}}}; [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu] [[Priyamvada Singh|Priyamvada Singh, MBBS]] [[mailto:psingh13579@gmail.com]] '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [[mailto:kfeeney@elon.edu]]
==Overview==
==Overview==
Magnetic resonance imaging can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.
[[Magnetic resonance imaging]] can be helpful as a [[diagnostic]] tool in conditions where the [[echocardiographic]] findings are inconclusive. It shows [[apical]] displacement of the [[septal]] and posterior leaflets of the [[Tricuspid valves|tricuspid valve]], arialization of the [[right ventricle]] and [[tricuspid regurgitation]].


==Magnetic resonance imaging==  
==Magnetic resonance imaging==  
Magnetic resonance imaging (MRI) can be used as a diagnostic modality in congenital heart diseases.
*[[Magnetic resonance imaging]] ([[MRI]]) can be used as a [[diagnostic]] modality in the evaluation of the [[patient]] who is suspected to have Ebstein's anomaly if the [[echocardiogram]] is inconclusive..<ref name="pmid7955830">{{cite journal |author=Eustace S, Kruskal JB, Hartnell GG |title=Ebstein's anomaly presenting in adulthood: the role of cine magnetic resonance imaging in diagnosis |journal=[[Clinical Radiology]] |volume=49 |issue=10 |pages=690–2 |year=1994 |month=October |pmid=7955830 |doi= |url= |issn= |accessdate=2012-10-20}}</ref><ref name="pmid30257686">{{cite journal |vauthors=Yang D, Li X, Sun JY, Cheng W, Greiser A, Zhang TJ, Liu H, Wan K, Luo Y, An Q, Chung YC, Han Y, Chen YC |title=Cardiovascular magnetic resonance evidence of myocardial fibrosis and its clinical significance in adolescent and adult patients with Ebstein's anomaly |journal=J Cardiovasc Magn Reson |volume=20 |issue=1 |pages=69 |date=September 2018 |pmid=30257686 |pmc=6158838 |doi=10.1186/s12968-018-0488-1 |url=}}</ref><ref name="pmid22014496">{{cite journal |vauthors=Kilner PJ |title=The role of cardiovascular magnetic resonance in adults with congenital heart disease |journal=Prog Cardiovasc Dis |volume=54 |issue=3 |pages=295–304 |date=2011 |pmid=22014496 |pmc=3245850 |doi=10.1016/j.pcad.2011.07.006 |url=}}</ref><ref name="pmid22723533">{{cite journal |vauthors=Kilner PJ |title=Imaging congenital heart disease in adults |journal=Br J Radiol |volume=84 Spec No 3 |issue= |pages=S258–68 |date=December 2011 |pmid=22723533 |pmc=3473918 |doi=10.1259/bjr/74240815 |url=}}</ref>
*It shows [[apical]] displacement of the [[septal]] and posterior leaflets of the [[Tricuspid valves|tricuspid valve]], arialization of the [[right ventricle]] and [[tricuspid regurgitation]].
====Advantages of MRI====
====Advantages of MRI====
* It can be used in cases where [[echocardiographic]] results are inconclusive.
* Helps in measuring [[heart]] [[Volume|volumes]], [[blood flow]] and [[ventricular]] wall thickness.
* The [[magnetic resonance angiography]] helps in better visualization of [[heart]] [[vasculature]] and measuring the size the [[pulmonary arteries]]
* Phase [[velocity]] mapping helps in measuring the ratio of [[pulmonary]] to [[systemic]] [[blood flow]] (Qp:Qs).


* It can be used in cases where echocardiographic results are inconclusive.
====Disadvantages of MRI====
* Helps in measuring heart volumes, blood flow and ventricular wall thickness.  
*For successful [[MRI]] procedure [[breath]] holding is required, which is sometimes difficult to achieve with small kids.
* The magnetic resonance angiography helps in better visualization of heart vasculature
*Some [[patients]] may become [[Claustrophobia|claustrophobic.]]
* Phase velocity mapping helps in measuring the ratio of pulmonary to systemic blood flow (Qp:Qs).  
*Due to the above, the procedure is sometimes done under [[general anesthesia]] in [[children]].
*There may be limited expertise to interpret the [[MRI]] as well.


Disadvantages of MRI
==ACC/AHA 2018 Guidelines for the Diagnostic recommendations of Adults With Ebstein Anomaly(DO NOT EDIT)<ref name="pmid30121239">{{cite journal |vauthors=Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, Crumb SR, Dearani JA, Fuller S, Gurvitz M, Khairy P, Landzberg MJ, Saidi A, Valente AM, Van Hare GF |title=2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines |journal=J. Am. Coll. Cardiol. |volume=73 |issue=12 |pages=e81–e192 |date=April 2019 |pmid=30121239 |doi=10.1016/j.jacc.2018.08.1029 |url=}}</ref><ref name="StoutDaniels2019">{{cite journal|last1=Stout|first1=Karen K.|last2=Daniels|first2=Curt J.|last3=Aboulhosn|first3=Jamil A.|last4=Bozkurt|first4=Biykem|last5=Broberg|first5=Craig S.|last6=Colman|first6=Jack M.|last7=Crumb|first7=Stephen R.|last8=Dearani|first8=Joseph A.|last9=Fuller|first9=Stephanie|last10=Gurvitz|first10=Michelle|last11=Khairy|first11=Paul|last12=Landzberg|first12=Michael J.|last13=Saidi|first13=Arwa|last14=Valente|first14=Anne Marie|last15=Van Hare|first15=George F.|title=2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease|journal=Journal of the American College of Cardiology|volume=73|issue=12|year=2019|pages=e81–e192|issn=07351097|doi=10.1016/j.jacc.2018.08.1029}}</ref>==


For successful MRI procedure breath holding is required, which is sometimes difficult to achieve with small kids. Due to this, the procedure is done under general anesthesia in children.
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
|bgcolor="LemonChiffon" |<nowiki></nowiki>'''1.'''. In adults with Ebstein anomaly, CMR(cardiac magnetic resonance imaging) can be useful to determine anatomy, RV dimensions, and systolic function. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''


==== Cardiac catheterization and hemodynamics ====
''<nowiki/>''
 
|}
a) RA pressure usually not increased due to the fact that the RA is enlarged and compliant.
 
b) Normal RV pressures unless significant [[TR]] is present.
 
c) PA pressures are normal or slightly decreased due to [[TR]] and a large right-to-left shunt.
 
d) An [[ASD]] may be present


==References==
==References==
{{Reflist}}
{{Reflist|2}}


{{Congenital malformations and deformations of circulatory system}}
{{WH}}  
{{WH}}  
{{WS}}
{{WS}}


Line 44: Line 45:
[[Category:Congenital heart disease]]
[[Category:Congenital heart disease]]
[[Category:Pediatrics]]
[[Category:Pediatrics]]
[[Category:Disease]]
[[Category:Medicine]
[[Category:Radiology]]

Latest revision as of 18:41, 18 February 2020

Ebsteins anomaly of the tricuspid valve Microchapters

Home

Patient Information

Overview

Historical Perpective

Classification

Pathophysiology

Causes

Differentiating Ebstein's Anomaly from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography

CT

MRI

Other Imaging Findings

Other diagnostic studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Case Studies

Case #1

Ebsteins anomaly of the tricuspid valve MRI On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ebsteins anomaly of the tricuspid valve MRI

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ebsteins anomaly of the tricuspid valve MRI

CDC on Ebsteins anomaly of the tricuspid valve MRI

Ebsteins anomaly of the tricuspid valve MRI in the news

Blogs on Ebsteins anomaly of the tricuspid valve MRI

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Ebsteins anomaly of the tricuspid valve MRI

Ebsteins anomaly of the tricuspid valve Microchapters

Home

Patient Information

Overview

Historical Perpective

Classification

Pathophysiology

Causes

Differentiating Ebstein's Anomaly from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography

CT

MRI

Other Imaging Findings

Other diagnostic studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Case Studies

Case #1

Ebsteins anomaly of the tricuspid valve MRI On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ebsteins anomaly of the tricuspid valve MRI

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ebsteins anomaly of the tricuspid valve MRI

CDC on Ebsteins anomaly of the tricuspid valve MRI

Ebsteins anomaly of the tricuspid valve MRI in the news

Blogs on Ebsteins anomaly of the tricuspid valve MRI

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Ebsteins anomaly of the tricuspid valve MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] and Claudia P. Hochberg, M.D. [2]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]}; Keri Shafer, M.D. [4] Priyamvada Singh, MBBS [[5]] Assistant Editor-In-Chief: Kristin Feeney, B.S. [[6]]

Overview

Magnetic resonance imaging can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive. It shows apical displacement of the septal and posterior leaflets of the tricuspid valve, arialization of the right ventricle and tricuspid regurgitation.

Magnetic resonance imaging

Advantages of MRI

Disadvantages of MRI

ACC/AHA 2018 Guidelines for the Diagnostic recommendations of Adults With Ebstein Anomaly(DO NOT EDIT)[5][6]

Class IIa
1.. In adults with Ebstein anomaly, CMR(cardiac magnetic resonance imaging) can be useful to determine anatomy, RV dimensions, and systolic function. (Level of Evidence: B)

References

  1. Eustace S, Kruskal JB, Hartnell GG (1994). "Ebstein's anomaly presenting in adulthood: the role of cine magnetic resonance imaging in diagnosis". Clinical Radiology. 49 (10): 690–2. PMID 7955830. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  2. Yang D, Li X, Sun JY, Cheng W, Greiser A, Zhang TJ, Liu H, Wan K, Luo Y, An Q, Chung YC, Han Y, Chen YC (September 2018). "Cardiovascular magnetic resonance evidence of myocardial fibrosis and its clinical significance in adolescent and adult patients with Ebstein's anomaly". J Cardiovasc Magn Reson. 20 (1): 69. doi:10.1186/s12968-018-0488-1. PMC 6158838. PMID 30257686.
  3. Kilner PJ (2011). "The role of cardiovascular magnetic resonance in adults with congenital heart disease". Prog Cardiovasc Dis. 54 (3): 295–304. doi:10.1016/j.pcad.2011.07.006. PMC 3245850. PMID 22014496.
  4. Kilner PJ (December 2011). "Imaging congenital heart disease in adults". Br J Radiol. 84 Spec No 3: S258–68. doi:10.1259/bjr/74240815. PMC 3473918. PMID 22723533.
  5. Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, Crumb SR, Dearani JA, Fuller S, Gurvitz M, Khairy P, Landzberg MJ, Saidi A, Valente AM, Van Hare GF (April 2019). "2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". J. Am. Coll. Cardiol. 73 (12): e81–e192. doi:10.1016/j.jacc.2018.08.1029. PMID 30121239.
  6. Stout, Karen K.; Daniels, Curt J.; Aboulhosn, Jamil A.; Bozkurt, Biykem; Broberg, Craig S.; Colman, Jack M.; Crumb, Stephen R.; Dearani, Joseph A.; Fuller, Stephanie; Gurvitz, Michelle; Khairy, Paul; Landzberg, Michael J.; Saidi, Arwa; Valente, Anne Marie; Van Hare, George F. (2019). "2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease". Journal of the American College of Cardiology. 73 (12): e81–e192. doi:10.1016/j.jacc.2018.08.1029. ISSN 0735-1097.

Template:WH Template:WS [[Category:Medicine]