AP chest xray in infant w tetralogy of Fallot shows a "boot | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

AP chest xray in infant w tetralogy of Fallot shows a "boot shaped heart" w upturned cardiac apex (black arrow) from RV hypertrophy/dilation. The pulmonic valve is absent w enlargement of the pulm arteries (white arrows). Absence of the pulmonic valve is found in 3% of ToF patients & leads to marked pulmonic regurgitation & compression of the trachea/bronchi by the pulm arteries. #ThoraxThursday



evaluating 61yo female with cardiac issue. What is the differential diagnosis? She has pulmonary valve stenosis and/or regurgitation with poststenotic dilation. Evidence of large pulmonary artery in ax T1 and sag snapshot (arrow). Valve stenosis corroborated on sag snapshot (arrows). Most other congenital anomalies are unlikely because she is 61 except for ASD. #cardiology #radiology #mrionline



pt with prior #Aortic-valve replacement (orange arrow) and #Mitral-valve repair (blue arrow), in for #Catheterization to check #Coronary-arteries for TAVR next month. Pt had #Rheumatic-fever as child. Previous valve replaced 2008, now needs new aortic valve.



Image Description: (A) Angiogram of left anterior descending coronary artery showing 100% occlusion without evidence of atherosclerotic coronary artery disease concerning for a septic embolus (blue arrow). (B) Transesophageal echo view showing medium-sized, 1.3 cm (L) × 1.0 cm (W), mobile vegetation on the atrial aspect of the tip of the anterior leaflet of mitral valve (red arrow). (C) Gross specimen showing vegetation involving the mitral valve leaflets. Case Description: Acute myocardial infarction (AMI) is a rare but recognized and potentially serious complication of infective endocarditis (IE). This case describes the challenges surrounding the management of AMI in the setting of septic coronary embolism, brain, spleen, and kidney infarcts due to septic emboli from native mitral valve IE.



An 11-year-old boy was admitted to the intensive care unit with respiratory distress and expectoration of bronchial casts every few days. He had a history of dextro-transposition of the great arteries (D-TGA) with ventricular septal defect (VSD) and coarctation of the aorta, for which he underwent neonatal arch repair, an arterial switch operation and VSD repair. The operations were complicated by a long period of renal failure, from which he recovered.

Subsequently, he underwent five more sternotomies to address the following issues:

At age 9 years, he required the following additional surgeries:

Over the prior two years, he developed severe tricuspid regurgitation, elevated right ventricular pressures and severe homograft valve regurgitation with mild stenosis of the branch pulmonary arteries. Despite having no related symptoms, his liver had been 4 cm below the right costal margin. Until this presentation, he had been relatively stable on diuretic therapy. Physical examination at presentation was particularly remarkable for an even more enlarged liver (5.5 cm below the right costal margin) and pronounced jugular venous distention. Cardiac catheterization confirmed elevated right-sided diastolic pressures. MR lymphangiogram revealed collateralization of obstructed lymphatic vessels. The team adopted a staged approach in which the pulmonary artery and pulmonary valve issues were first corrected, as these could be approached percutaneously. The patient underwent left pulmonary artery stenting and transcatheter pulmonary valve replacement. Despite that, he progressed to daily cast formation and respiratory failure. The decision-making at this point was to proceed to a more invasive strategy to address the remaining right-sided lesions. He underwent surgical repair of the tricuspid valve, with improvement of his right-sided pressures.



A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.



A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.



A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.



patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?