30 year old with history of idiopathic pulmonary arterial hypertension presenting for evaluation of possible ventricular septal defect seen on echocardiography. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 64%, the LV end diastolic volume index is 57 ml/m2 (normal range: 65+/-11), the LVEDV is 97 ml (normal range 109+/-23), the LV end systolic volume index is 20 ml/m2 (normal range 18+/-5), the LVESV is 35 ml (normal range 31+/-10), the LV mass index is 24 g/m2 (normal range 67+/-11), and the LV mass is 42 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is severely dilated with moderate to severe systolic dysfuction. The overall RV ejection fraction is 18%, the RV end diastolic volume index is 156 ml/m2 (normal range 69+/-14), the RVEDV is 266 ml (normal range 110+/-24), the RV end systolic volume index is 127 ml/m2 (normal range 22+/-8), and the RVESV is 217 ml (normal range 35+/-13). Right AtriumThe right atrium is severely enlarged. The coronary sinus is enlarged. 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 mild pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild to moderate tricuspid regurgitation.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size. The main PA size is 39 mm, the right PA size is 27 mm, and the left PA size is 23 mm.Venous AnatomyThe SVC and IVC drain normally into the right atrium. The IVC is dilated.ShuntsThere are multiple intracardiac or extracardiac shunts present. There is a small membranous VSD. There is a sinus venosus ASD comprised of 3 anomalous venous branches draining into the SVC. The pulmonary artery flow is 45 ml and the aortic flow is 46 ml. Qp:Qs = 0.98PericardiumThere 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 normal in size with normal systolic function. The overall LV ejection fraction is 64%2. The right ventricle is severely dilated with moderate to severe systolic dysfuction. The overall RV ejection fraction is 18%3. Sinus venosus ASD. Three anomalous veins draining into the SVC. Qp:Qs = 0.984. Small membranous VSD5. Severe dilatation of the main PA. Dilated branch PAs. Measurements above.6. Mild-moderate TR.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.