A 76 year old female with personal history of atrial fibrillation, s/p ablation, hypertension, hypothyroidism, vertigo now hospitalized with wide complex tachycardia in the setting of a presyncope. Referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is mildly dilated with low normal systolic function. The overall LV ejection fraction is 51%, the LV end diastolic volume index is 91 ml/m2 (normal range: 65+/-11), the LVEDV is 175 ml (normal range 109+/-23), the LV end systolic volume index is 45 ml/m2 (normal range 18+/-5), the LVESV is 87 ml (normal range 31+/-10), the LV mass index is 50 g/m2 (normal range 67+/-11), and the LV mass is 96 g (normal range 114+/-24). There is a very small region of transmural late gadolinium enhancement in the apical inferolateral wall; this segment is thin and hypokinetic. This finding probably represents an small embolic myocardial infarction.There is no intracavitary thrombus.Left AtriumThe left atrium is mildly dilated. The LA volume is 118 ml.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 55%, the RV end diastolic volume index is 82 ml/m2 (normal range 69+/-14), the RVEDV is 156 ml (normal range 110+/-24), the RV end systolic volume index is 37 ml/m2 (normal range 22+/-8), and the RVESV is 70 ml (normal range 35+/-13). No fatty infiltration or focal wall motion abnormality is noted. No findings compatible with ARVD diagnosis.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 trivial pericardial effusion.Extracardiac FindingsThere is a large pleural effusion on the left and small one on the right. A large hiatal hernia is 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 mildly dilated with low normal systolic function, the LVEF is 51%. 2. There is a very small region of transmural late gadolinium enhancement in the apical inferolateral wall; this segment is thin and hypokinetic. This finding probably represents an small embolic myocardial infarction.3. The left atrium is mildly dilated.4. The right ventricle is normal in size with normal systolic function, the RVEF is 55%. No findings compatible with ARVD diagnosis.5. See extra-cardiac findings.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.