55 year old male with history of DVT/PE, HTN, DM, hemachromatosis (heterozygous), and family history of premature CAD who presents for evaluation of possible cardiac involvement of sarcoidosis given history of palpitations/PVCs. Left VentricleThe left ventricle is normal in size with low normal systolic function (LVEF 54%). The overall LV ejection fraction is 54%, the LV end diastolic volume index is 93 ml/m2 (normal range: 74+/-15), the LVEDV is 210 ml (normal range 142+/-34), the LV end systolic volume index is 43 ml/m2 (normal range 25+/-9), the LVESV is 98 ml (normal range 47+/-19), the LV mass index is 32 g/m2 (normal range 85+/-15), and the LV mass is 72 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is gadolinium enhancement in the mid lateral and inferolateral walls and the basal inferolateral wall in the mid to subendocardial distribution. This, along with the mediastinal lymphadenopathy, is suggestive of cardiac sarcoidosis. No intracardiac thrombus.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 58%, the RV end diastolic volume index is 88 ml/m2 (normal range 82+/-16), the RVEDV is 199 ml (normal range 142+/-31), the RV end systolic volume index is 37 ml/m2 (normal range 31+/-9), and the RVESV is 84 ml (normal range 54+/-17).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 no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is evidence of tricuspid regurgitation which is not quantified.AortaThere is a left sided aortic arch with a common origin of the innominate and left common carotid artery. The aortic root is mildly dilated (SoV 44 mm, Ascending Aorta 34 mm on coronal views/non-orthogonal plane images).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 drain normally into the right atrium.PericardiumThere is no pericardial effusion.Extracardiac FindingsThere is stable mediastinal lymphadenopathy (right paratracheal, aortopulmonary, right hilar and sub carinal).
1. The left ventricle is normal in size with low normal systolic function (LVEF 54%). There is left ventricular gadolinium enhancement which is mid myocardial and subendocardial n the mid lateral and inferolateral walls and the basal inferolateral wall. This, along with the mediastinal lymphadenopathy, is suggestive of cardiac sarcoidosis.2. The right ventricle is normal in size and systolic function (RVEF 58%)3. Mild dilatation of the sinus of Valsalva. 