43 year old woman with PH, RHF, referred for evaluation of underlying infiltrative disease or fibrosis. Left VentricleThe left ventricle is small in size with mildly reduced systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 45 ml/m2 (normal range: 65+/-11), the LVEDV is 91 ml (normal range 109+/-23), the LV end systolic volume index is 25 ml/m2 (normal range 18+/-5), the LVESV is 50 ml (normal range 31+/-10). LV dysfunction is global. There is septal flattening consistent with elevated RV pressures.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is enlarged with severely reduced systolic function. The overall RV ejection fraction is 23%, the RV end diastolic volume index is 87 ml/m2 (normal range 69+/-14), the RVEDV is 175 ml (normal range 110+/-24), the RV end systolic volume index is 67 ml/m2 (normal range 22+/-8), and the RVESV is 136 ml (normal range 35+/-13). Right AtriumThe right atrium is severely dilated. Aortic ValveThe aortic valve opens widely and there is trace aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is mild pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There at least moderate tricuspid regurgitation.AortaThere is a left sided aortic arch with a psuedo-bovine 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 a small pericardial effusion.Extracardiac FindingsThere are small bilateral pleural effusions. This 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 small in size with mildly reduced systolic function. The overall LV ejection fraction is 45%. LV dysfunction is global. There is septal flattening consistent with elevated RV pressures.2. Delayed enhancement imaging was not able to be obtained today due to contrast extravasation at IV insertion site. Recommend repeat administration/imaging in following day when better IV access available.3. The right ventricle is enlarged with severely reduced systolic function. The overall RV ejection fraction is 23%. RV dysfunction is global.4. Severe right atrial dilation.5. At least moderate tricuspid regurgitation.