65 year old with reduced left ventricular systolic performance, nonobstructive coronary disease, atrial fibrillation, hypertension, significant PVC burden and syncope presenting for evaluation of cardiomyopathy. Left VentricleThe left ventricle is upper normal in size with moderately-severely reduced systolic function. The overall LV ejection fraction is 33 %, the LV end diastolic volume index is 101 ml/m2 (normal range: 74+/-15), the LVEDV is 235 ml (normal range 142+/-34), the LV end systolic volume index is 69 ml/m2 (normal range 25+/-9), the LVESV is 159 ml (normal range 47+/-19). The left ventricular systolic dysfunction is global with regional variation. 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 normal in size and systolic function. The overall RV ejection fraction is 49%, the RV end diastolic volume index is 74 ml/m2 (normal range 82+/-16), the RVEDV is 169 ml (normal range 142+/-31), the RV end systolic volume index is 37 ml/m2 (normal range 31+/-9), and the RVESV is 85 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is trace aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is trace mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is trace 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 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 normal in size with moderately-severely reduced systolic function (LV EF33%). The left ventricular systolic dysfunction is global with regional variation. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The right ventricle is normal in size and systolic function (RVEF49%) 