41 year old with no past medical history presenting after witnessed cardiac arrest during running event. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 64%, the LV end diastolic volume index is 76 ml/m2 (normal range: 74+/-15), the LVEDV is 160 ml (normal range 142+/-34), the LV end systolic volume index is 27 ml/m2 (normal range 25+/-9), the LVESV is 57 ml (normal range 47+/-19), the LV mass index is 55 g/m2 (normal range 85+/-15), and the LV mass is 116 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is a small epicardial region of late gadolinium enhancement involving the basal inferolateral wall. The pattern is atypical for prior myocardial infarction and suggests the presence of underlying myocardial fibrosis, inflammation, or infiltration. This pattern of LGE/ fibrosis is non-specific and has even been described in frequent marathon runners.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 66%, the RV end diastolic volume index is 72 ml/m2 (normal range 82+/-16), the RVEDV is 152 ml (normal range 142+/-31), the RV end systolic volume index is 24 ml/m2 (normal range 31+/-9), and the RVESV is 51 ml (normal range 54+/-17). There is no focal RV wall motion abnormality or aneurysm. No evidence of RV fat infiltration or late gadolinium enhancement.Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild 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.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 no obvious pericardial disease.Coronary Arteries. Normal origin of the coronary arteries.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. Normal LV size and systolic function (LVEF 64%) with evidence of mild atypical late gadolinium enhancement of the basal inferolateral wall. The pattern is atypical for prior myocardial infarction and suggests the presence of underlying myocardial fibrosis, inflammation, or infiltration. This pattern of LGE/ fibrosis is non-specific and has even been described in frequent marathon runners.2. Normal RV size and systolic function (RVEF 66%). No cardiac MRI of arrhythmogenic right ventricular dysplasia.3. Normal coronary artery origins. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.