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eFigure 12–13. CT shows endovascular repair of a thoracoabdominal aneurysm utilizing component technology to insert grafts into the major aortic branches. A color CT scan shows grafts inserted into the major aortic branches.

Current Medical Diagnosis & Treatment 2023 > Thoracic Aortic Aneurysms

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eFigure 26–22. A: Left infrarenal pheochromocytoma shown by CT scanning. B: Diagram identifies many of the visible structures. (Reproduced with permission from Greenspan FS, Strewler GJ. Basic & Clinical Endocrinology, 5th ed. McGraw-Hill Companies Inc.; 1997.) A scan shows the presence of a tumor between the bowel and vertebrae. An illustration shows the presence of a tumor between the bowel and vertebrae. Kidney, ureter, aorta, and vena cava are also identified.

Current Medical Diagnosis & Treatment 2023 > Pheochromocytoma & Paraganglioma

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eFigure 26–22. A: Left infrarenal pheochromocytoma shown by CT scanning. B: Diagram identifies many of the visible structures. (Reproduced with permission from Greenspan FS, Strewler GJ. Basic & Clinical Endocrinology, 5th ed. McGraw-Hill Companies Inc.; 1997.) A scan shows the presence of a tumor between the bowel and vertebrae. An illustration shows the presence of a tumor between the bowel and vertebrae. Kidney, ureter, aorta, and vena cava are also identified.

Current Medical Diagnosis & Treatment 2023 > Pheochromocytoma & Paraganglioma

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eFigure 16–59. Acute pancreatitis. CT shows diffuse enlargement of the pancreas (P) with dilated bile duct (arrow) and pancreatic duct (arrowheads). L, liver; a, aorta; K, kidneys; s, superior mesenteric artery. (Reproduced, with permission, from Krebs CA, Giyanani VL, Eisenberg RL. Ultrasound Atlas of Disease Processes. Originally published by Appleton & Lange. Copyright © 1993 by The McGraw-Hill Companies, Inc.) A radiograph of the abdomen in a transverse view reveals a mass on the pancreas.

Current Medical Diagnosis & Treatment 2023 > Acute Pancreatitis

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eFigure 10–15. Schematic drawing of pulmonary stenosis. See text for details. LA, left atrium; RA, right atrium; RV, right ventricle; Ao, aorta; PA, pulmonary artery. Reproduced with permission from Obgyn Key. Obgyn Key Website, https://obgynkey.com/pulmonary-stenosis-pulmonary-atresia-with-intactventricular-septum-and-ductus-arteriosus-constriction/. A schematic diagram depicts pulmonary stenosis.

Current Medical Diagnosis & Treatment 2023 > Pulmonary Valve Stenosis

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eFigure 10–27. A: The ascending aorta (yellow dotted line) leading into the arch is dilated, whereas the distal arch and descending aorta (red dotted line) are normal in size. The left heart border (blue dotted line) can be traced upwards along the mediastinum to blend with the aortic arch, explaining why the medial (left) border of the ascending aorta is not visible on radiographs. B: CTA of the thorax confirms enlargement of the ascending aorta with a normal caliber descending aorta. Source: https://radiopaedia.org/cases/aortic-valve-stenosis-1. Case used with permission from Dr. Frank Gaillard, Radiopaedia.org, rID: 15391. Copyright 2020 Dr. Frank Gaillard. Used under license. A chest x ray reveals an enlarged ascending aorta, while the descending aorta appears normal. A chest x ray in the lateral view, reveals an enlarged ascending aorta, and a normal sized descending aorta.

Current Medical Diagnosis & Treatment 2023 > Valvular Heart Disease

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eFigure 10–27. A: The ascending aorta (yellow dotted line) leading into the arch is dilated, whereas the distal arch and descending aorta (red dotted line) are normal in size. The left heart border (blue dotted line) can be traced upwards along the mediastinum to blend with the aortic arch, explaining why the medial (left) border of the ascending aorta is not visible on radiographs. B: CTA of the thorax confirms enlargement of the ascending aorta with a normal caliber descending aorta. Source: https://radiopaedia.org/cases/aortic-valve-stenosis-1. Case used with permission from Dr. Frank Gaillard, Radiopaedia.org, rID: 15391. Copyright 2020 Dr. Frank Gaillard. Used under license. A chest x ray reveals an enlarged ascending aorta, while the descending aorta appears normal. A chest x ray in the lateral view, reveals an enlarged ascending aorta, and a normal sized descending aorta.

Current Medical Diagnosis & Treatment 2023 > Valvular Heart Disease

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eFigure 10–30. The patient had further investigations and was diagnosed with a bicuspid aortic valve. A CTA of the aorta did not reveal aortic dissection. (Reproduced, with permission, from Pouraliakbar H. Chest radiography in cardiovascular disease. In: Maleki M, Alizadehasl A, Haghjoo M. Practical Cardiology. Elsevier, 2018. Copyright © Elsevier.) A chest x ray with arrows indicating the enlargement of cardiac chamber in a case of bicuspid aortic valve.

Current Medical Diagnosis & Treatment 2023 > Mitral Stenosis

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eFigure 10–32. Aortic stenosis. A: Drawing of the left heart in left anterior oblique view showing anatomic features of aortic stenosis. Note structures enlarged: LV (thickened); poststenotic dilation of the aorta. (Reproduced, with permission, from Hammer GD, McPhee SJ. Pathophysiology of Disease, 8th ed. McGraw-Hill, 2019.) B: Drawing showing auscultatory and hemodynamic features of predominant aortic stenosis. Cardinal features include LVH and systolic ejection murmur. (EC, ejection click; SM, systolic murmur; P, pulmonary valve; A, aortic valve.) (Reproduced with permission from Cheitlin MD et al, eds. Clinical Cardiology, 6th ed. Appleton & Lange: The McGraw-Hill Companies Inc, 1993.) C: Pressure-volume loop in aortic stenosis. The LV becomes thickened and less compliant, forcing the diastolic pressure-volume curve upward, which results in elevated LV end-diastolic pressure (a′). Because the LV must pump against a fixed gradient (increased afterload), b increases to b′. Finally, the hypertrophy of the ventricle results in increased inotropic force, which shifts the isovolumic pressure curve leftward. A three-part illustration depicts the hemodynamic changes in aortic stenosis. A chest x ray reveals an enlargement of the heart in the lower quadrant, resulting from aortic stenosis.

Current Medical Diagnosis & Treatment 2023 > Aortic Stenosis

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eFigure 10–32. Aortic stenosis. A: Drawing of the left heart in left anterior oblique view showing anatomic features of aortic stenosis. Note structures enlarged: LV (thickened); poststenotic dilation of the aorta. (Reproduced, with permission, from Hammer GD, McPhee SJ. Pathophysiology of Disease, 8th ed. McGraw-Hill, 2019.) B: Drawing showing auscultatory and hemodynamic features of predominant aortic stenosis. Cardinal features include LVH and systolic ejection murmur. (EC, ejection click; SM, systolic murmur; P, pulmonary valve; A, aortic valve.) (Reproduced with permission from Cheitlin MD et al, eds. Clinical Cardiology, 6th ed. Appleton & Lange: The McGraw-Hill Companies Inc, 1993.) C: Pressure-volume loop in aortic stenosis. The LV becomes thickened and less compliant, forcing the diastolic pressure-volume curve upward, which results in elevated LV end-diastolic pressure (a′). Because the LV must pump against a fixed gradient (increased afterload), b increases to b′. Finally, the hypertrophy of the ventricle results in increased inotropic force, which shifts the isovolumic pressure curve leftward. A three-part illustration depicts the hemodynamic changes in aortic stenosis. A chest x ray reveals an enlargement of the heart in the lower quadrant, resulting from aortic stenosis.

Current Medical Diagnosis & Treatment 2023 > Aortic Stenosis

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Figure 10–4. Algorithm for the timing of intervention in aortic valve stenosis. AS, aortic stenosis; AVA, aortic valve area; AVAi, aortic valve area index; AVR, aortic valve replacement; BP, blood pressure; DSE, dobutamine stress echocardiography; ETT, exercise treadmill test; DPmean, mean systolic pressure gradient between LV and aorta; SAVR, surgical aortic valve replacement; SVI, stroke volume index; TAVI, transcatheter aortic valve implantation; TAVR, transcatheter aortic valve replacement; Vmax, maximum velocity. (Reprinted from Journal of the American College of Cardiology,77, Otto CM et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines, e25–e197, 2021, with permission from Elsevier.) A flowchart for the timing of intervention in aortic valve stenosis.

Current Medical Diagnosis & Treatment 2023 > Aortic Stenosis

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