76 year old with history of left ventricular systolic dysfunction, hypertension, end stage renal disease and concern for right atrial mass presenting for evaluation of RA mass. Left VentricleThe left ventricle is moderately dilated (severely when indexed for BSA) with mildly reduced systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 120 ml/m2 (normal range: 65+/-11), the LVEDV is 181 ml (normal range 109+/-23), the LV end systolic volume index is 66 ml/m2 (normal range 18+/-5), the LVESV is 100 ml (normal range 31+/-10), the LV mass index is 91 g/m2 (normal range 67+/-11), and the LV mass is 137 g (normal range 114+/-24). The LV systolic dysfunction is global. 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 61%, the RV end diastolic volume index is 96 ml/m2 (normal range 69+/-14), the RVEDV is 144 ml (normal range 110+/-24), the RV end systolic volume index is 37 ml/m2 (normal range 22+/-8), and the RVESV is 56 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. There is no clear mass seen on T1 and T2 weighted imaging. Notably imaging is limited by poor breath hold and lack of gadolinium (due to ESRD). 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 no obvious pericardial disease.Extracardiac FindingsThere are large bilateral pleural effusions, left greater than right with left lower lobe atelectasis. Hepatic cysts and moderately enlarged kidneys with innumerable cysts. Small focus of T2 hyperintensity in mid-lower thoracic spine (1.1x1.3cm). 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 moderately dilated with mildly reduced systolic function (LVEF 45%)2. The right ventricle is normal in size with normal systolic function (RVEF 61%)3. The right atrium is normal in size. There is no clear mass seen on T1 and T2 weighted imaging in the right atrium. Notably imaging is limited by poor breath hold and lack of gadolinium (due to ESRD). 