44 year old female with DM, HTN, fibromyalgia, DKA, syncope and unexplained LVOT gradient with SAM of the mitral valve. Left VentricleThe left ventricle is normal in size with mild concentric hypertrophy and normal systolic function. The overall LV ejection fraction is 73%. The LVEDV is 127 ml (normal range 109+/-23), LV end diastolic volume index is 88 ml/m2 (normal range: 65+/-11), LVESV is 35 ml (normal range 31+/-10), and LV end systolic volume index is 24 ml/m2 (normal range 18+/-5). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. There is evidence for flow acceleration in the LVOT.The native T1 myocardial relaxation time is upper normal and similar in the septum and other myocardial segments. There is no LV thrombus. There is mild sigmoid hypertrophy of the interventricular septum.Left AtriumThe left atrium is normal in size.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 45%, the RVEDV is 177 ml (normal range 110+/-24), the RV end diastolic volume index is 122 ml/m2 (normal range 69+/-14), the RVESV is 98 ml (normal range 35+/-13) and the RV end systolic volume index is 68 ml/m2 (normal range 22+/-8).Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve is trileaflet, 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. CVenous AnatomyThe SVC and IV drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.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.Normal sized left ventricle with mild concentric hypertrophy and hyperdynamic systolic function.2.Normal sized right ventricle with normal systolic function.3.Mild sigmoid hypertrophy of interventricular septum.4.No evidence of infiltrative disorder.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.