Identify the labeling correctly ![img-3.jpeg](img-3.jpeg)

A - Ascending aorta, B - Pulmonary trunk, C - Superior vena cava, D - Descending aorta

A - Ascending aorta, B - Superior vena cava, C - Pulmonary trunk, D - Descending aorta

A - Superior vena cava, B - Pulmonary trunk, C - Ascending aorta, D - Descending aorta

A - Pulmonary trunk, B - Ascending aorta, C - Superior vena cava, D - Descending aorta

A - Ascending aorta, B - Pulmonary trunk, C - Descending aorta, D - Superior vena cava

For pericardial calcifications, which is the best investigation?

Transesophageal echocardiography

Cardiovascular Anatomy for INI-CET: High-Yield Radiology Lessons

Heart Chambers & Valves - Pump & Flow Gates

📌 Mnemonic (Valve sequence): Try Pulling My Aorta.

Septa: Interatrial (fossa ovalis); Interventricular (membranous, muscular).
LV Wall: Normal <1.1 cm.

Chamber	Key Features	Valve	Views (Echo/MRI)
RA	Crista terminalis, pectinate mm.	TV	A4C, Subcostal
RV	Moderator band, trabeculae	PV	A4C, PSAX
LA	Pulmonary vein ostia (4)	MV	A4C, A2C
LV	Thick wall, smooth tracts	AV	A4C, A2C, PSAX, A3C

*   Tricuspid (TV): **3**; RA → RV.
*   Pulmonary (PV): **3** (semilunar); RV → Pulm. Artery.
*   Mitral (MV): **2** (bicuspid); LA → LV.
*   Aortic (AV): **3** (semilunar); LV → Aorta.

⭐ The moderator band (RV), containing the right bundle branch, is a key landmark identifying the morphological RV.

Great Vessels - Major Highway Pipes

Chest X-ray with cardiovascular anatomy labels

Great vessels: major conduits for blood. Normal ascending aorta diameter <3.5-3.8 cm.

Vessel	Origin	Course Highlights	Key Branches/Tributaries	Radiological Significance
Aorta	LV	Ascending, Arch, Descending	Brachiocephalic, LCCA, LSA (Arch); Thoracic & Abd. br.	Aortic Knob, AP Window
Pulmonary Artery (PA)	RV	Main PA → RPA & LPA	-	AP Window; PA dilatation
Pulmonary Veins	Lungs	Typically 4 → LA	-	Venous congestion patterns
SVC	Brachiocephalic vv.	Drains upper body	Azygos v.	Central line path
IVC	Common Iliac vv.	Drains lower body	Hepatic, Renal vv.	IVC filters, displacement

Key CXR Signs:
- Aortic Knob: Aortic arch shadow.
- Aortopulmonary (AP) Window: Space below arch, above L pulmonary artery.

⭐ The ligamentum arteriosum, a remnant of the fetal ductus arteriosus, connects the proximal left pulmonary artery to the aortic arch distal to the left subclavian artery origin.

Coronary Circulation - Heart's Fuel Lines

Supplies oxygenated blood to myocardium. Stenosis >70% significant.

Coronary Arteries Table:

Artery	Origin	Key Branches	Myocardial Territory
LMCA	L Aortic Sinus	LAD, LCx	Ant, Lat, Septal LV
LAD	LMCA	Septals (S), Diagonals (D)	Ant wall, Apex, Ant-septum, BBs
LCx	LMCA	Obtuse Marginals (OM)	Lat & Post-lat LV, Ant-lat pap muscle
RCA	R Aortic Sinus	Conus, SA Nodal, Acute Marg (AM), AV Nodal, PDA (R-dom)	RA, RV, SA/AV nodes, Inf wall & Post-septum (R-dom)

Coronary Dominance: Determined by PDA origin.
- Right Dominance (~85%): PDA from RCA.
- Left Dominance (~8%): PDA from LCx.
- Co-dominant (~7%): PDA from RCA, PLV from LCx.

⭐ SA nodal artery: RCA (60%), LCx (40%).

Major Cardiac Veins:
- Great Cardiac Vein (with LAD).
- Middle Cardiac Vein (with PDA).
- Small Cardiac Vein (with RCA).
- Drain to Coronary Sinus → Right Atrium (RA).

Coronary Artery Angiography Views and Anatomy

Pericardium & Mediastinal Interfaces - Sac & Shadows

Pericardium:
- Outer: Fibrous. Inner: Serous (parietal, visceral).
- Cavity: Between serous layers. Normal fluid: 15-50 mL. Thickness: <2mm.
Pericardial Recesses:
- Transverse sinus: Post. to aorta/pulm. trunk, ant. to SVC.
- Oblique sinus: Post. to Left Atrium (LA).
  
  ⭐ The oblique sinus is a cul-de-sac posterior to the LA, bounded by pericardial reflections around pulmonary veins & IVC.
Mediastinal Interfaces (CXR) & CV Structures:
- Paratracheal Stripes (R/L): SVC abuts right.
- Aortopulmonary (AP) Window: Formed by aortic arch & L pulm. artery.
- Azygoesophageal Recess: Azygos vein forms posterior border.
- Junction Lines (Ant/Post): Heart shadow contributes to anterior. & CXR mediastinal lines (cardiovascular))

High‑Yield Points - ⚡ Biggest Takeaways

Cardiothoracic Ratio (CTR) on PA chest X-ray: < 0.5 is normal.

Right heart border: primarily Right Atrium (RA).

Left heart border & apex: formed by the Left Ventricle (LV).

Aortic Knob: represents the distal aortic arch on CXR.

Main Pulmonary Artery (MPA) shadow is typically seen inferior to the aortic knob.

Key coronary arteries: LAD, LCx (from LCA) and RCA.

Normal pericardial thickness is < 2 mm; increased in pericarditis/effusion.

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