28 year old male with a history of non-ischemic cardiomyopathy s/p heart transplant in 4/2016, hypertension, history of pericarditis now with chest pain. Referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 59 ml/m2 (normal range: 74+/-15), the LVEDV is 140 ml (normal range 142+/-34), the LV end systolic volume index is 27 ml/m2 (normal range 25+/-9), the LVESV is 63 ml (normal range 47+/-19), the LV mass index is 28 g/m2 (normal range 85+/-15), and the LV mass is 66 g (normal range 164+/-36). There is no myocardial late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pre-contrast native myocardial T1 relaxation times are normal (1000-1050 ms). The ECV fraction is also within normal limits. The global relative enhancement ratio is mildly elevated (4.8).Left AtriumThe left atrium is consistent with transplant morphology. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 56 ml/m2 (normal range 82+/-16), the RVEDV is 134 ml (normal range 142+/-31), the RV end systolic volume index is 28 ml/m2 (normal range 31+/-9), and the RVESV is 66 ml (normal range 54+/-17).Right AtriumThe right atrium is consistent with transplant.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 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 evidence of pericardial late gadolinium enhancement suggesting pericardial inflammation or fibrosis. There is no CMR evidence of constriction based on myocardial tagging and absence of interventricular septal variation with respiration. Extracardiac FindingsThere are sternotomy wires present consistent with previous surgery. 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 normal in size and systolic function (LVEF 55%) without any late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The right ventricle is normal in size and normal in systolic function (RVEF 50%).3. There is evidence of pericardial late gadolinium enhancement suggesting pericardial inflammation or fibrosis. No evidence of pericardial constriction. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.