66 year old female with history of orthotopic heart transplant in 6/2015 for non ischemic cardiomyopathy, hypertension, anxiety and GERD now presenting with chest pain, a small pericardial effusion, neck stiffness, and possible meningitis. Referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size. The overall LV ejection fraction is 60%, the LV end diastolic volume index is 75 ml/m2 (normal range: 65+/-11), the LVEDV is 150 ml (normal range 109+/-23), the LV end systolic volume index is 30 ml/m2 (normal range 18+/-5), the LVESV is 60 ml (normal range 31+/-10). There are no regional wall motion abnormalities present. There is no myocardial late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is dilated consistent with transplant morphology.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 46%, the RV end diastolic volume index is 91 ml/m2 (normal range 69+/-14), the RVEDV is 181 ml (normal range 110+/-24), the RV end systolic volume index is 49 ml/m2 (normal range 22+/-8), and the RVESV is 98 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant 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. PericardiumSmall pericardial effusion. There is evidence for pericardial inflammation by T2stir images and delayed enhancement in the pericardium. No myocardial extension of inflammation was noted.Extracardiac FindingsPost heart transplant surgery findings. Small bilateral pleural effusions. Parenchymal lung process, most prominent in LLL. 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. Normal biventricular size and systolic function.2. Small pericardial effusion with evidence for pericardial inflammation.3. Abnormal lung MRI findings.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.