Preliminary Diagnosis: Atrial Septal Defect
I. What imaging technique is first-line for this diagnosis
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2-D Echocardiography
II. Describe the advantages and disadvantages of this technique for diagnosis.
Advantages
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Highly portable imaging modality.
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Does not expose patients to ionizing radiation.
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Highly sensitive and specific in detecting cardiac structural abnormalities and cardiac chamber pressures.
Disadvantages
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Limited in evaluating the surrounding soft tissues.
III. What are the contraindications for the first-line imaging technique?
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No specific contraindications to echocardiography exist
IV. What alternative imaging techniques are available?
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Plain Radiography of the Chest (PA and Lateral)
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Cardiac MR.
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis.
Plain Radiography of the Chest (PA and Lateral)
Advantages
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Fast and portable imaging modality.
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Exposes patients to minimal ionizing radiation.
Disadvantages
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Less sensitive and specific in detailing the cardiomediastinal silhouette, pericardium, and cardiac chambers.
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Unable to evaluate the pressure measurements within the cardiac chambers and valvular structures.
Cardiac MR
Advantages
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Sensitive and specific in detecting the flow and directionality of blood throughout the cardiac chambers and surrounding great vessels
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Gold standard in evaluating cardiac structure including valvular and chamber architecture.
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Does not expose patients to ionizing radiation.
Disadvantages
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Expensive
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Time consuming
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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)
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No specific contraindications to plain radiography exist. Some insitutions may require signed consent for pregnant women
Cardiac MR
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Contraindicated in patients with non MR compatible hardware.
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