Curriculum in cardiac imaging

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A suggested curriculum in cardiac imaging has been established by the North American Society of Cardiac Imaging.

The original document can be viewed here.

Physiological aspects of cardiac imaging

 * 1) Normal cardiac cycle (systole and diastole)
 * 2) * Systole and diastole
 * 3) * Ventricular function
 * 4) * Atrial function
 * 5) * Valvular function
 * 6) Electrocardiography
 * 7) * Control of excitation and conduction in the heart
 * 8) * Characteristics of normal sinus rhythm
 * 9) * Common abnormalities in EKG
 * 10) ** Premature atrial contraction / premature ventricular contraction
 * 11) ** Atrial fibrillation / atrial flutter / Atrioventricular block
 * 12) ** Current of injury (signs of myocardial ischemia and infarction)
 * 13) Physiologic anatomy of cardiac muscle
 * 14) Mechanics of cardiac contraction
 * 15) Physical basis for blood flow, pressure and resistance
 * 16) * Ventricular volume and pressure relationship
 * 17) ** Preload
 * 18) ** Afterload
 * 19) * Practical cardiac measurements
 * 20) ** Ejection fraction
 * 21) ** Stroke volume
 * 22) ** Cardiac Output
 * 23) ** Left ventricular mass
 * 24) ** Flow calculation (Q = V x A)
 * 25) ** Gradient calculation (Bernoulli equation, G = 4 x PV2)
 * 26) ** Qp/Qs ratio
 * 27) * Normal cardiac and pulmonary pressures
 * 28) * Vascular regions supplied by the coronary arteries
 * 29) * Standard nomenclature for topographic imaging of the heart

Anatomy of the heart and great vessels

 * 1) Normal morphology and structure
 * 2) * Embryology
 * 3) * Fetal circulation
 * 4) * Normal cardiac and peri-cardiac structures to include
 * 5) ** Eustachian valve
 * 6) ** Thebesian valve / coronary sinus
 * 7) ** Right and left atrial appendages
 * 8) ** Moderator band
 * 9) ** Endocardial cushion
 * 10) ** Atrioventricular valves (tricuspid and mitral)
 * 11) ** Semilunar valves (aortic and pulmonic)
 * 12) ** Sinus of Valsalva
 * 13) ** Coronary arteries and major branches
 * 14) ** Coronary veins including coronary sinus
 * 15) ** Superior vena cava and deep mediastinal veins (e.g. azygous vein)
 * 16) ** Pericardium
 * 17) ** Pulmonary arteries
 * 18) ** Pulmonary veins
 * 19) * Common variants
 * 20) ** Anomalous coronary artery
 * 21) ** Persistent left superior vena cava
 * 22) ** Azygous continuation of the inferior vena cava
 * 23) Segmental Anatomy of the Heart
 * 24) * Atrial situs
 * 25) * Ventricular situs
 * 26) * Identification of great vessels
 * 27) * Assess pulmonary arteries and veins
 * 28) * Identify systemic venous return
 * 29) Normal Adult Heart Measurements
 * 30) * Left ventricular wall thickness, diameter, fractional shortening and end-diastolic volume and volume index
 * 31) * Left atrium size
 * 32) * Right ventricular wall thickness and size
 * 33) * Right atrial size
 * 34) * Diameter of the thoracic aorta

Techniques for imaging the heart and great vessels

 * 1) Radiography
 * 2) Computed tomography
 * 3) * Indications
 * 4) ** Coronary calcium scoring
 * 5) ** Cardiac CT
 * 6) ** Coronary CTA
 * 7) * Physics and cardiac imaging considerations including ECG gating techniques
 * 8) ** Coronary artery calcium scoring
 * 9) ** Coronary CTA
 * 10) ** Aortic CTA
 * 11) ** Pulmonary CTA
 * 12) * Advantages and Limitations
 * 13) Magnetic resonance imaging
 * 14) * Indications
 * 15) * Physics and imaging considerations, including pulse sequences, ECG-gating techniques, and respiratory compensation strategies
 * 16) ** Wall motion studies
 * 17) ** Myocardial perfusion and viability scanning
 * 18) ** Valvular disease assessment
 * 19) ** Blood flow quantification
 * 20) ** Coronary MRA
 * 21) ** MR of the aorta
 * 22) ** Pulmonary MRA
 * 23) ** Atherosclerotic plaque evaluation
 * 24) * Advantages, Limitations and contraindications
 * 25) Cardiac Scintigraphy (including PET)
 * 26) * Indications
 * 27) * Physics and cardiac imaging considerations
 * 28) ** Multiple-gated acquisition (MUGA)
 * 29) ** Myocardial perfusion and viability scanning
 * 30) ** Shunt evaluation
 * 31) * Advantages and Limitations
 * 32) Other (working understanding)
 * 33) * Echocardiography (transthoracic and transesophageal)
 * 34) ** Indications
 * 35) ** Technique including standard views and use of color Doppler
 * 36) ** Advantages and Limitations
 * 37) * Cardiac and coronary catheter angiography
 * 38) ** Indications
 * 39) ** Technique including standard views and transcatheter tools (e.g. intraluminal ultrasound)
 * 40) ** Advantages and Limitations

Congenital heart disease: Basic

 * 1) Cyanotic versus acyanotic presentations
 * 2) Most common lesions:
 * 3) * Ventricular septal defect
 * 4) * Patent ductus arteriosus
 * 5) * Atrial septal defect
 * 6) * Tetralogy of Fallot
 * 7) * Pulmonary stenosis
 * 8) * Obstruction of the aorta (aortic coarctation and interruption of the aorta)
 * 9) * Transposition of the great vessels (D- vs. L-transposition)
 * 10) * Endocardial cushion defect
 * 11) * Aortic valvular disease
 * 12) * Total anomalous pulmonary venous connection and Partial anomalous pulmonary venous connection
 * 13) * Truncus arteriosus
 * 14) * Vascular rings
 * 15) Situs Anomalies and (asplenia and polysplenia)

Unusual congenital heart disease: Advanced

 * 1) Double outlet right ventricle
 * 2) Single ventricle
 * 3) Cor Triatriatum
 * 4) Hypoplastic left heart syndrome
 * 5) * Aortic atresia
 * 6) * Mitral atresia
 * 7) Hyopoplastic right heart syndrome
 * 8) * Tricuspid atresia
 * 9) * Uhl’s anomaly
 * 10) * Right ventricular dysplasia
 * 11) * Pulmonary valve atresia
 * 12) * Ebstein’s anomaly
 * 13) Congenital absence of the pericardium
 * 14) Indications for and post-operative assessment of
 * 15) * Mustard
 * 16) * Senning
 * 17) * Rastelli
 * 18) * Fontan
 * 19) * Norwood
 * 20) * Jatene
 * 21) * Blalock-Taussig
 * 22) * Potts
 * 23) * Waterston-Cooley
 * 24) * Glenn
 * 25) * Rashkind
 * 26) * Ross Procedure
 * 27) Late or Adult presentations of congenital heart disease
 * 28) * Mitral valve prolapse
 * 29) * Aortic stenosis (e.g. valvular and subvalvular)
 * 30) * Sinus of Valsalva aneurysm
 * 31) * Marfan’s syndrome
 * 32) * Bicuspid aortic valve

Ischemic heart disease

 * 1) Risk factors, primary prevention and screening
 * 2) Inducible myocardial ischemia
 * 3) Acute MI
 * 4) Chronic MI
 * 5) Post-MI complications
 * 6) * Cardiac rupture
 * 7) * LV aneurysm
 * 8) * Papillary muscle rupture
 * 9) * Congestive heart failure
 * 10) * Dressler’s syndrome
 * 11) Myocardial viability
 * 12) * Stunned myocardium
 * 13) * Hibernating myocardium
 * 14) * Therapeutic and interventional options

Valvular Heart Disease

 * 1) Aortic stenosis
 * 2) * Valvular aortic stenosis
 * 3) * Subvalvular aortic stenosis
 * 4) * Supravalvular aortic stenosis
 * 5) ** William’s syndrome
 * 6) Aortic insufficiency
 * 7) Mitral stenosis / mitral insufficiency
 * 8) * Parachute mitral valve
 * 9) Tricuspid stenosis / tricuspid regurgitation
 * 10) Miscellaneous:
 * 11) * Degenerative calcification
 * 12) ** Calcified aortic stenosis
 * 13) ** Mitral annular calcification
 * 14) * Myxomatous degeneration
 * 15) * Carcinoid syndrome
 * 16) * Infective endocarditis
 * 17) * Rheumatic heart disease
 * 18) Therapeutic and interventional options

Cardiac and pericardial masses

 * 1) Primary lesions
 * 2) * Myxoma
 * 3) * Lipoma
 * 4) * Angiosarcoma
 * 5) * Rhabdomyoma
 * 6) Metastasis
 * 7) Therapeutic and interventional options

Acquired diseases of the thoracic aorta

 * 1) Aneurysms
 * 2) * Atherosclerotic
 * 3) * Marfan’s syndrome
 * 4) * Ehlers-Danlos syndrome
 * 5) Pseudoaneurysms
 * 6) * Mycotic
 * 7) Post-traumatic and post-surgical
 * 8) * Dissection
 * 9) ** Intramural hematoma
 * 10) * Aortitis
 * 11) * Atherosclerosis
 * 12) ** Plaque
 * 13) ** Penetrating ulcer
 * 14) * Therapeutic and interventional options

Cardiomyopathy

 * 1) Hypertrophic cardiomyopathy
 * 2) * Idiopathic hypertrophic subaortic stenosis
 * 3) Dilated Cardiomyopathy
 * 4) ** Ischemic
 * 5) ** Non-ischemic


 * 1) Restrictive (also infiltrative) cardiomyopathy
 * 2) * Amyloidosis
 * 3) ** Sarcoidosis
 * 4) ** Storage diseases
 * 5) ** Infection
 * 6) ** Radiation
 * 7) * Therapeutic and interventional options

Diseases of the Pericardium

 * 1) Acute pericarditis
 * 2) Constrictive pericarditis
 * 3) Pericardial effusion
 * 4) Pericardial cyst
 * 5) Pericardial defect
 * 6) Therapeutic and interventional options

Miscellaneous

 * 1) Arrhythmogenic Right Ventricular Dysplasia (ARVD)
 * 2) Coronary artery / sinus of Valsalva aneurysm and fistula
 * 3) Pulmonary arterial hypertension
 * 4) Pulmonary embolism
 * 5) Cardiac transplantation
 * 6) Automatic Inplantable Cardioverter Defibrillator (AICD)
 * 7) Pacemakers
 * 8) RF ablation for atrial fibrillation

Cardiovascular Protocols

 * MR Angiography for Pulmonary Embolism
 * Acute Chest Pain Imaging