15 year old male with idiopathic ventricular tachycardia. Evaluation for possible etiology. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. There is mild hypokinesis of the basal inferior wall. The overall LV ejection fraction is 47%. The LVEDV is 147 ml (normal range 142+/-34), the LV end diastolic volume index is 74 ml/m2 (normal range: 74+/-15), the LVESV is 78 ml (normal range 47+/-19) and the LV end systolic volume index is 39 ml/m2 (normal range 25+/-9). The LV mass is 145 g (normal range 164+/-36) and the LV mass index is 73 g/m2 (normal range 85+/-15). There is a 1cm thick band of epicardial late gadolinium enhancement in a single basal to mid ventricular short axis slice along the inferior, inferolateral, and anterolateral wall. The pattern of LGE is not consistent with prior myocardial infarction. The myocardium that has late gadolinium enhancement also has evidence of increased signal of SSFP and T2-stir. Together this suggests that the most likely diagnosis is myocarditis in the inflammatory stage. Left AtriumThe left atrium is normal in size.. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 52%. The RVEDV is 140 ml (normal range 142+/-31), RV end diastolic volume index is 71 ml/m2 (normal range 82+/-16), the RVESV is 68 ml (normal range 54+/-17), and the RV end systolic volume index is 34 ml/m2 (normal range 31+/-9).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 mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size. The left and right coronary arteries originate normally from the aortic root. 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. Normal left ventricular size with mildly reduced systolic function (LVEF 47%) with subtle basal to mid inferior wall hypokinesis. There is evidence of a circumferential band of epicardial late gadolinium enhancement involving the basal to mid ventricle along the inferior, inferolateral, and anterolateral wall. The pattern of LGE is not consistent with prior myocardial infarction and the most likely diagnosis is myocarditis in the inflammatory stage. 2. Normal right ventricular size and systolic function (RVEF 52%)3. Normal origin of the coronary arteries. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.