59 year old female with biopsy-proven sarcoidosis (bronchoscopic LN biopsy with non-necrotizing granulomas) and palpitations referred to rule out cardiac involvement. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 56%, the LV end diastolic volume index is 63 ml/m2 (normal range: 65+/-11), the LVEDV is 140 ml (normal range 109+/-23), the LV end systolic volume index is 28 ml/m2 (normal range 18+/-5), the LVESV is 62 ml (normal range 31+/-10). There are no regional wall motion abnormalities present. There is a subtle region of subepicardial late gadolinium enhancement involving the basal inferior and inferolateral walls which spares the endocardium and is atypical for prior myocardial infarction. This has not changed from previous CMR done1/2014. The finding could suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is moderately dilated. 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 58 ml/m2 (normal range 69+/-14), the RVEDV is 140 ml (normal range 110+/-24), the RV end systolic volume index is 28 ml/m2 (normal range 22+/-8), and the RVESV is 78 ml (normal range 35+/-13). 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-moderate 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 normal in size. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsMediastinal and hilar lymphadenopathy noted. 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. Normal LV size and systolic function (LVEF 56%).2. There is a subtle region of late gadolinium enhancement involving the basal inferior and inferolateral walls which spares the endocardium and is atypical for prior myocardial infarction. This could suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process; however, this finding has not changed from previous CMR dated 1/2014.3. Normal RV size and systolic function (RVEF 50%).4. Moderate LA dilation.