57 year old male with a past medical history significant for atrial fibrillation/flutter with multiple ablations, non-ischemic cardiomyopathy, hypertension and ventricular tachycardia. Referred for cardiac MRI prior to further decision making. Left VentricleThe left ventricle is normal in size with mild to moderately depressed systolic function. The overall LV ejection fraction is 39%. The LVEDV is 189 ml (normal range 142+/-34), the LV end diastolic volume index is 75 ml/m2 (normal range: 74+/-15), the LVESV is 114 ml (normal range 47+/-19) and the LV end systolic volume index is 46 ml/m2 (normal range 25+/-9). The LV mass is 97 g (normal range 164+/-36) and the LV mass index is 39 g/m2 (normal range 85+/-15). The ventricular septum is hypokinetic. There is mid myocardial late gadolinium enhancement in the area of the basal septum suggesting an underlying fibrosing, infiltrative, or inflammatory process.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 59%. The RVEDV is 159 ml (normal range 142+/-31), RV end diastolic volume index is 64 ml/m2 (normal range 82+/-16), the RVESV is 66 ml (normal range 54+/-17), and the RV end systolic volume index is 27 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve is not well visualized.Mitral ValveThe mitral valve opens widely and there is at least mitral regurgitation.Pulmonic ValveThe pulmonic valve is not well visualized.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation. AICD lead is noted passing from the right atrium through the tricuspid valve and into the RV apex.AortaThere is a left sided aortic arch. The branches are not well seen due to AICD artifact.. Pulmonary VeinsThree pulmonary veins drain normally into the left atrium. The left upper pulmonary vein was not well visualized.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe SVC and IVC normally into the right atrium.PericardiumThere is no obvious pericardial disease.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.
Interpretation is limited by artifact from AICD/PM.1.Normal LV size with mild-moderately depressed systolic function (LVEF 39%). Septal hypokinesis noted.2.There is mid myocardial late gadolinium enhancement in the area of the basal septum suggesting an underlying fibrosing, infiltrative, or inflammatory process.3.Normal RV size with normal systolic function (RVEF 59%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.