72 year old with history of hypertension, frequent premature ventricular contractions, and mildly reduced systolic function Left VentricleThe left ventricle is mild to moderately dilated (quantitative measurements suggest more severe left ventricular dilation but qualitative assessment is more suggestive of mild to moderate enlargement) with low normal systolic function. The overall LV ejection fraction is 54%, the LV end diastolic volume index is 118 ml/m2 (normal range: 65+/-11), the LVEDV is 188 ml (normal range 109+/-23), the LV end systolic volume index is 54 ml/m2 (normal range 18+/-5), the LVESV is 85 ml (normal range 31+/-10), the LV mass index is 59 g/m2 (normal range 67+/-11), and the LV mass is 92 g (normal range 114+/-24). There is late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process on the epicardial side of the basal anteroseptal, anterior and anterolateral walls with associated hypokinesis of the basal antero-septal wall. This pattern of LGE is more on the apical side and is atypical for myocardial infarction. Left AtriumThe left atrium is at least moderately dilated.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 53%, the RV end diastolic volume index is 86 ml/m2 (normal range 69+/-14), the RVEDV is 134 ml (normal range 110+/-24), the RV end systolic volume index is 40 ml/m2 (normal range 22+/-8), and the RVESV is 63 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly to 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 trivial mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is trivial 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 are normal in size and drain normally into the right atrium. PericardiumThere is a small circumferential pericardial effusion.Extracardiac FindingsThis 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 mild to moderately dilated (quantitative measurements suggest more severe left ventricular dilation but qualitative assessment is more suggestive of mild to moderate enlargement) with low normal systolic function. The overall LV ejection fraction is 54% There is LGE of the subepicardial basal anteroseptal, anterior and anterolateral walls with associated hypokinesis of the basal antero-septal wall. This pattern of LGE is more on the apical side and is atypical for myocardial infarction. 2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 53%