25 year old with history of peripartum cardiomyopathy presenting for cardiac evaluation after abnormal echocardiogram. Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 48%, the LV end diastolic volume index is 89 ml/m2 (normal range: 65+/-11), the LVEDV is 163 ml (normal range 109+/-23), the LV end systolic volume index is 46 ml/m2 (normal range 18+/-5), the LVESV is 85 ml (normal range 31+/-10), the LV mass index is 37 g/m2 (normal range 67+/-11), and the LV mass is 68 g (normal range 114+/-24). The LV dysfunction is global. There a nontransmural, mid-myocardial stripe of late gadolinium enhancement in the basal to mid septal wall in the non coronary pattern and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. This may represent a previous myocarditis episode or other cause of non-ischemic cardiomyopathy.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 63%, the RV end diastolic volume index is 71 ml/m2 (normal range 69+/-14), the RVEDV is 129 ml (normal range 110+/-24), the RV end systolic volume index is 26 ml/m2 (normal range 22+/-8), and the RVESV is 48 ml (normal range 35+/-13). 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 "pseudobovine" 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 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 mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 48%. The LV dysfunction is global. There nontransmural, mid-myocardial stripe of late gadolinium enhancement in the basal to mid septal wall in the non coronary pattern to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. This may represent previous myocarditis episode or another cause of non-ischemic cardiomyopathy. Additionally the native myocardial T1 relaxation time is mild to moderately increased and suggests the presence of diffuse myocardial interstitial fibrosis.2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 63%. 