73 year old male with CAD (unclear history), cardiomyopathy, HTN, hyperlipidemia. Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 43%, the LV end diastolic volume index is 105 ml/m2 (normal range: 74+/-15), the LVEDV is 205 ml (normal range 142+/-34), the LV end systolic volume index is 60 ml/m2 (normal range 25+/-9), the LVESV is 117 ml (normal range 47+/-19), the LV mass index is 53 g/m2 (normal range 85+/-15), and the LV mass is 104 g (normal range 164+/-36). There is global hypokinesis. There is late gadolinium enhancement present along the mid-wall and epicardial boundary circumferentially along the base and mid ventricle to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern is atypical for myocardial infarction and also for cardiac amyloidosis. No evidence of myocardial iron overload. Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 49%, the RV end diastolic volume index is 79 ml/m2 (normal range 82+/-16), the RVEDV is 155 ml (normal range 142+/-31), the RV end systolic volume index is 40 ml/m2 (normal range 31+/-9), and the RVESV is 79 ml (normal range 54+/-17).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 mild 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 mildly dilated.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThe esophagus is patulous. 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. Mild left ventricular dilation with mildly reduced systolic function (LVEF 43%). 2. There is late gadolinium enhancement present along the mid-wall and epicardial boundary circumferentially along the base and mid ventricle to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern is atypical for myocardial infarction and also for cardiac amyloidosis.3. Normal right ventricular size with mildly reduced systolic function (RVEF 49%).4. Mild dilation of the main pulmonary artery.5. Patulous esophagus noted. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.