Ischaemic and Non-Ischaemic Cardiomyopathies, Congenital Heart Disease, and Pericardial Diseases — WACS Viva & Clinical Scenarios (Chest and Cardiovascular Imaging)

Exam-style ischaemic and non-ischaemic cardiomyopathies, congenital heart disease, and pericardial diseases viva scenarios with examiner probes and model…

Scenarios covered

• SCENARIO 1: A 48-year-old male presents with new-onset heart failure and non-sustained ventricular tachycardia. Cardiac magnetic resonance (CMR) imaging is performed with late gadolinium enhancement (LGE). Describe the systematic approach to interpreting LGE patterns to differentiate ischaemic cardiomyopathy from non-ischaemic cardiomyopathies, including dilated cardiomyopathy, hypertrophic cardiomyopathy, cardiac amyloidosis, and acute myocarditis.
• SCENARIO 2: A 35-year-old female presents with progressive dyspnoea, elevated jugular venous pressure with prominent y-descent, and peripheral oedema. Contrast-enhanced thoracic CT and cine CMR are requested to differentiate constrictive pericarditis from restrictive cardiomyopathy. Outline the key radiographic, CT, and MRI imaging findings that establish this diagnostic distinction.
• SCENARIO 3: A 6-month-old infant presents with central cyanosis and failure to thrive. Plain chest radiography demonstrates decreased pulmonary vascularity and a classic abnormal cardiac silhouette. Detail the diagnostic evaluation of cyanotic and acyanotic congenital heart lesions, contrasting the imaging appearances of Tetralogy of Fallot, Transposition of the Great Arteries, and Coarctation of the Aorta.
• SCENARIO 4: A 62-year-old male develops sudden cardiovascular collapse and a new harsh pansystolic murmur five days after an acute anterior ST-elevation myocardial infarction. Discuss the role of urgent echocardiography, CT, and cardiac MRI in differentiating acute ventricular septal defect, papillary muscle rupture, true left ventricular aneurysm, and left ventricular pseudoaneurysm.
• SCENARIO 5: A 40-year-old female presents with long-standing dyspnoea and orthopnoea secondary to chronic rheumatic heart disease. Detail the sequential chest radiographic signs of left atrial and right ventricular enlargement and the progressive stages of pulmonary venous hypertension from cephalisation to alveolar pulmonary oedema.