A 54 year old female with recently diagnosed non-ischemic cardiomyopathy, severe left ventricular dysfunction and significant mitral regurgitation. Now the patient is hospitalized because of acute decompensated heart failure and referred to cardiac MRI to further evaluate the etiology and severity of the cardiomyopathy. Left VentricleThe left ventricle is severely dilated with severe systolic dysfunction. The overall LV ejection fraction is 20%, the LV end diastolic volume index is 129 ml/m2 (normal range: 65+/-11), the LVEDV is 261 ml (normal range 109+/-23), the LV end systolic volume index is 104 ml/m2 (normal range 18+/-5), the LVESV is 210 ml (normal range 31+/-10), the LV mass index is 64 g/m2 (normal range 67+/-11), and the LV mass is 130 g (normal range 114+/-24). There is global hypokinesis with regional dyskinesis. No iron overload was noted. Native myocardial T1 is mildly increased, most pronounced in the interventricular septum, which suggests that there might be underlying midwall myocardial fibrosis present.Left AtriumThe left atrium is mildly dilated dilated. The LA volume is 102 ml.Right VentricleThe right ventricle is normal in size with moderate systolic function. The overall RV ejection fraction is 35%, the RV end diastolic volume index is 52 ml/m2 (normal range 69+/-14), the RVEDV is 105 ml (normal range 110+/-24), the RV end systolic volume index is 80 ml/m2 (normal range 22+/-8), and the RVESV is 162 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation with limited images.Mitral ValveThe mitral valve opens widely and there is at least moderate mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation with limited images.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.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.Extracardiac FindingsMild left pleural effusion was noted. Small mediastinal lymph nodes are 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. The left ventricle is severely dilated with severe systolic dysfunction, LVEF is 20%. There is global hypokinesis with regional dyskinesis. No evidence of myocardial iron overload. Native myocardial T1 is mildly increased, most pronounced in the interventricular septum, which suggests that there might be underlying midwall myocardial fibrosis present. No late gadolinium enhancement imaging was performed due to patient inability to complete exam. As a consequence, the presence of other infiltrative cardiomyopathies or other specific etiologies can not be determined.2. The right ventricle is normal in size with moderate systolic function, RVEF is 35%. 3. The left atrium is mildly dilated dilated. 4. The mitral valve opens widely and there is at least moderate mitral regurgitation.5. Small pericardial effusion is noted.6. See extra-cardiac findings.