A 56 year old male with suspected hypertrophic cardiomyopathy by echocardiography. Referred to cardiac MRI for further evaluation Left VentricleThe left ventricle is normal in size and systolic function. There is mid to apical chamber obliteration at end systole. The overall LV ejection fraction is 62%, the LV end diastolic volume index is 54 ml/m2 (normal range: 74+/-15), the LVEDV is 114 ml (normal range 142+/-34), the LV end systolic volume index is 21 ml/m2 (normal range 25+/-9), the LVESV is 43 ml (normal range 47+/-19), the LV mass index is 52 g/m2 (normal range 85+/-15), and the LV mass is 110 g (normal range 164+/-36). Hypertrophy was noted diffusely at the basal and mid segments reaching a maximum of 16 mm at the basal antero-septum. There are no regional wall motion abnormalities present. There is are punctate foci of high signal within the interventricular septum, at the insertion of the right ventricular free wall, most notable at the mid chamber level. No other enhancement is identified.No cardiac iron overload noted.No findings compatible with amyloid.On the 3 chamber view during systole, there is an intracavitary jet which is suggestive of a mild resting gradient within the chamber in the subvalvular LVOT (at site of maximal wall thickness).No intracardiac thrombus.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 58%, the RV end diastolic volume index is 61 ml/m2 (normal range 82+/-16), the RVEDV is 129 ml (normal range 142+/-31), the RV end systolic volume index is 26 ml/m2 (normal range 31+/-9), and the RVESV is 54 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. There is a hockey-stick configuration to the anterior leaflet which may be the result of prior rheumatic disease. There is mild to moderate systolic anterior motion of the anterior leaflet of the mitral valve. There is transient non coaptation as a result, at early diastole. No significant mitral regurgitation is identified; dedicated 3 plane imaging was not performed.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 pericardial effusion.
1. Near concentric basal hypertrophy with additional thickening of the interventricular septum. The maximal thickness is 16 mm at end diastole. Mid to apical chamber obliteration at end systole. Left ventricular ejection fraction equals 62%. Punctate foci of intermediate high signal noted at the interventricular septum at the insertion of the right ventricular free wall. Mitral SAM is present. The consolation of findings are suggestive of hypertrophic cardiomyopathy.2. Right ventricular wall thickness is normal with well-preserved systolic function. The right ventricular ejection fraction equals 58%.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.