72 year old with history of coronary artery disease, dyslipidemia and apical hypertrophic cardiomyopathy presenting for evaluation for cardiac function and scar. Left VentricleThe left ventricle is normal in size and ventricular function. LV ejection fraction is 66%, the LV end diastolic volume index is 94 ml/m2 (normal range: 74+/-15), the LVEDV is 173 ml (normal range 142+/-34), the LV end systolic volume index is 32 ml/m2 (normal range 25+/-9), the LVESV is 59 ml (normal range 47+/-19), the LV mass index is 66 g/m2 (normal range 85+/-15), and the LV mass is 121 g (normal range 164+/-36). There is apical hypertrophy which results in obliteration of the apical 1/3 of the ventricle in systole. Associated enhancement of the hypertrophied segments.No intracardiac thrombus.Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 60%, the RV end diastolic volume index is 103 ml/m2 (normal range 82+/-16), the RVEDV is 189 ml (normal range 142+/-31), the RV end systolic volume index is 41 ml/m2 (normal range 31+/-9), and the RVESV is 75 ml (normal range 54+/-17). No right ventricular hypertrophy or enhancement.Right AtriumThe right atrium is mildly dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant 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 three vessel arch. 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 no pericardial effusion.
1. Normal left ventricular size and function (LVEF 66%). There is apical hypertrophy with obliteration of the apical cavity at systole. Enhancement of the apical hypertrophic segments consistent with fibrosis. 2. Normal right ventricular size and function (RVEF 60%). No evidence of apical hypertrophy.3. Mild biatrial enlargement.