18 year old with history of kawasaki's disease in childhood, presenting for cardiac evaluation after syncopal event. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 56%, the LV end diastolic volume index is 111 ml/m2 (normal range: 74+/-15), the LVEDV is 222 ml (normal range 142+/-34), the LV end systolic volume index is 49 ml/m2 (normal range 25+/-9), the LVESV is 97 ml (normal range 47+/-19), the LV mass index is 78 g/m2 (normal range 85+/-15), and the LV mass is 154 g (normal range 164+/-36). 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. Native T1 times are normal (1000 ms) also suggesting that there is no underlying myocardial fibrosis or edema. Right VentricleThe right ventricle is moderately dilated with mildly reduced systolic function. The overall RV ejection fraction is 45%, the RV end diastolic volume index is 138 ml/m2 (normal range 82+/-16), the RVEDV is 274 ml (normal range 142+/-31), the RV end systolic volume index is 75 ml/m2 (normal range 31+/-9), and the RVESV is 149 ml (normal range 54+/-17). There are no focal RV free wall aneurysms or focal wall motion abnormalities. AtriaNormal left atrial size. The right atrium is moderately dilated. No atrial septal defect identified. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is trace 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 coronary arteries originate from the appropriate cusps with no clear evidence of aneurysm in the left main, proximal and mid LAD, the proximal and mid RCA, or the proximal LCx. 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 a small pericardial effusion with no evidence of hemodynamic compromise. Extracardiac FindingsResidual thymus gland noted. 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. Normal LV size and systolic function (LVEF 56%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration.2. Moderate right ventricular dilation with mildly reduced systolic function (RVEF 45%); however, no evidence of focal RV wall motion abnormality or aneurysm. 3. Moderate right atrial dilation. 4. Normal origin of the coronary arteries without evidence of coronary aneurysm is the proximal to mid portion of the major coronary vessels.5. No obvious intra-cardiac shunt noted.6. Small pericardial effusion.