A 78 year old male hospitalized because of osteomyelitis and right below knee amputation because, recent diagnosis of congestive heart failure with left ventricular ejection fraction of 36%, moderately reduced right ventricular function, severe aortic regurgitation, moderate tricuspid regurgitation and severe aortic root dilation. Referred to cardiac MRI for further evaluation Left VentricleThe left ventricle is severely dilated with severely reduced systolic function. The overall LV ejection fraction is 28%, the LV end diastolic volume index is 231 ml/m2 (normal range: 74+/-15), the LVEDV is 411 ml (normal range 142+/-34), the LV end systolic volume index is 166 ml/m2 (normal range 25+/-9), the LVESV is 296 ml (normal range 47+/-19), the LV mass index is 127 g/m2 (normal range 85+/-15), and the LV mass is 226 g (normal range 164+/-36). There is global severe hypokinesis with regional variation. Left AtriumThe left atrium is moderately dilated (142ml). Right VentricleThe right ventricle is mildly dilated with moderately reduced systolic function. The overall RV ejection fraction is 37%, the RV end diastolic volume index is 126 ml/m2 (normal range 82+/-16), the RVEDV is 224 ml (normal range 142+/-31), the RV end systolic volume index is 79 ml/m2 (normal range 31+/-9), and the RVESV is 140 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately dilated.Aortic ValveThe aortic valve opens widely and there is severe aortic regurgitation (non-dedicated sequences)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. In non-dedicated sequences, the aortic root is severely dilated and the ascending aorta is mildly dilated. The arch and descending thoracic aorta are normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is mildly dilated (33mm).Venous AnatomyThe SVC and IVC drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsBilateral pleural effusion were seen: moderate on the right and mild on the left. 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 severely dilated with severely reduced systolic function, the LVEF is 28%. There is global severe hypokinesis with regional variation. 2. The right ventricle is mildly dilated with moderately reduced systolic function, the RVEF is 37%. 3. There is moderate biatrial dilation. 4. There is severe aortic regurgitation.5. The aortic root is severely dilated and the ascending aorta is mildly dilated. The aortic arch and thoracic descending aorta are within normal limites. 6. The main pulmonary artery is mildly dilated (33mm).7. See extra-cardiac findings.8. Only non-contrast images were acquired due to patient inability to complete contrast portions of the study (i.e. there are no late gadolinium enhancement or MRA images acquired).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.