46 year old male with a history of left ventricular dysfunction, atrial flutter, and hypertension referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with low normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 102 ml/m2 (normal range: 74+/-15), the LVEDV is 260 ml (normal range 142+/-34), the LV end systolic volume index is 48 ml/m2 (normal range 25+/-9), the LVESV is 122 ml (normal range 47+/-19), the LV mass index is 96 g/m2 (normal range 85+/-15), and the LV mass is 245 g (normal range 164+/-36). There is mild left ventricular hypertrophy, predominantly involving the septum (mid septum 10-12mm). There is a thick patch of late gadolinium enhancement involving the basal inferoseptal wall. The pattern of late gadolinium enhancement is atypical for prior myocardial infarction and suggests the presence of an underlying myocardial fibrosing, inflammatory, or infiltrative process. There is no evidence of myocardial iron overload.Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 62%, the RV end diastolic volume index is 103 ml/m2 (normal range 82+/-16), the RVEDV is 262 ml (normal range 142+/-31), the RV end systolic volume index is 39 ml/m2 (normal range 31+/-9), and the RVESV is 100 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 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 are normal in size and drain normally into the right atrium.PericardiumThere is a small pericardial effusion. Extracardiac FindingsSmall bilateral pleural effusions are 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. The left ventricle is normal in size with low normal systolic function (LVEF 53%). 2. The right ventricle is normal in size with normal systolic function (LVEF 62%). 3. There is mild left ventricular hypertrophy, predominantly involving the septum (mid septum 12-14mm). Within the thickened septum, there is a patch of late gadolinium enhancement involving the basal inferoseptal wall. The pattern of late gadolinium enhancement is atypical for prior myocardial infarction and suggests the presence of an underlying myocardial fibrosing, inflammatory, or infiltrative process.4. There is a small pericardial effusion. 5. See extra-cardiac findings. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.