65 year old woman with sarcoidosis referred to evaluate for possible cardiac sarcoidosis. Left VentricleThe left ventricle is moderately dilated with moderately reduced systolic function. The overall LV ejection fraction is 36%, the LV end diastolic volume index is 99 ml/m2 (normal range: 65+/-11), the LVEDV is 225 ml (normal range 109+/-23), the LV end systolic volume index is 64 ml/m2 (normal range 18+/-5), the LVESV is 145 ml (normal range 31+/-10), the LV mass index is 68 g/m2 (normal range 67+/-11), and the LV mass is 155 g (normal range 114+/-24). There is global hypokinesis with regional wall motion abnormalities. The basal to mid inferior and inferolateral walls are thinned and most hypokinetic. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 43%, the RV end diastolic volume index is 70 ml/m2 (normal range 69+/-14), the RVEDV is 160 ml (normal range 110+/-24), the RV end systolic volume index is 40 ml/m2 (normal range 22+/-8), and the RVESV is 91 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 at least moderate 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 no obvious pericardial disease.Extracardiac FindingsThere is a large burden of mediastinal lymphadenopathy. 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. Moderate left ventricular dilation with moderately reduced systolic function (LVEF 36%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration. 2. There is pronounced thinning and hypokinesis of the basal inferior and inferolateral walls. These segments are free of myocardial infarction. This abnormality could represent hibernating myocardium due to the presence of a severe coronary artery stenosis supplying viable myocardium. 3. Normal right ventricular size with mildly reduced systolic function (RVEF 43%).4. Severe left atrial dilation.5. At least moderate mitral regurgitation. 6. See extra-cardiac findings. 