71 year old female with breast cancer on Doxorubicin with new diagnosis of heart failure with reduced ejection fraction. Coronary angiogram demonstrated moderate coronary artery disease including a 100%, small distal LAD occlusion. Left VentricleThe left ventricle is severely dilated with severely reduced systolic function . The overall LV ejection fraction is 20%, the LV end diastolic volume index is 123 ml/m2 (normal range: 65+/-11), the LVEDV is 228 ml (normal range 109+/-23), the LV end systolic volume index is 98 ml/m2 (normal range 18+/-5), the LVESV is 183 ml (normal range 31+/-10), the LV mass index is 31 g/m2 (normal range 67+/-11), and the LV mass is 57 g (normal range 114+/-24). There is global hypokinesis with regional variation. There is subendocardial late gadolinium enhancement of the inferior and septal apex that is consistent myocardial infarction and less likely suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. T1 mapping, T2 stir not performed as scan was done on 3T scanner. Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is mildly dilated with moderately reduced systolic function . The overall RV ejection fraction is 34%, the RV end diastolic volume index is 111 ml/m2 (normal range 69+/-14), the RVEDV is 207 ml (normal range 110+/-24), the RV end systolic volume index is 74 ml/m2 (normal range 22+/-8), and the RVESV is 138 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is at least mild to moderate mitral regurgitation.Pulmonic ValveThe pulmonic valve not well visualized.Tricuspid ValveThe tricuspid valve opens widely. There is at least mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size. Venous AnatomyThe SVC and IVC drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsLarge bilateral pleural effusions. This study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered.
1. The left ventricle is severely dilated with severely reduced systolic function (LVEF 20%). There is global hypokinesis with regional variation.2. The right ventricle is mildly dilated with moderately reduced systolic function (RVEF 34%). 3. There is subendocardial late gadolinium enhancement of the inferior and septal apex is consistent myocardial infarction of the distal LAD territory.4. Mildly dilated left atrium, moderately dilated right atrium. 5. At least mild-moderate mitral regurgitation.6. Large bilateral pleural effusions. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.