43 year old male with history of recent viral illness and LV dysfunction, referred for possible myocarditis. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 51%, the LV end diastolic volume index is 94 ml/m2 (normal range: 74+/-15), the LVEDV is 215 ml (normal range 142+/-34), the LV end systolic volume index is 46 ml/m2 (normal range 25+/-9), the LVESV is 106 ml (normal range 47+/-19). There is hypokinesis of the basal-mid inferior and inferolateral walls. There is no evidence for myocardial edema (T2 STIR myocardial:skeletal ratio<2). There is a mid-myocardial focus of late gadolinium enhancement in the basal inferolateral wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. It is atypical for myocardial infarction.There is no LV thrombus. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 85 ml/m2 (normal range 82+/-16), the RVEDV is 194 ml (normal range 142+/-31), the RV end systolic volume index is 41 ml/m2 (normal range 31+/-9), and the RVESV is 94 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant 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 drain normally into the right atrium.PericardiumThere is a trivial pericardial effusion.Extracardiac FindingsThis 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 normal in size with mildly reduced systolic function (EF = 51%). There is mild inferior / inferolateral hypokinesis.2. There is a midmyocardial focus of late gadolinium enhancement in the basal inferolateral wall which is atypical from previous myocardial infarction, and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. The right ventricle is normal in size with normal systolic function (EF 52%). I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.