A 58 year old male with paroxysmal atrial fibrillation, hypertension, diabetes mellitus and asthma. Referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 83 ml/m2 (normal range: 74+/-15), the LVEDV is 168 ml (normal range 142+/-34), the LV end systolic volume index is 37 ml/m2 (normal range 25+/-9), the LVESV is 75 ml (normal range 47+/-19), the LV mass index is 62 g/m2 (normal range 85+/-15), and the LV mass is 126 g (normal range 164+/-36). There is transmural late gadolinium enhancement at the basal lateral and infero-lateral walls. This findings could be consistent with prior myocardial infarction or alternatively suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. These segments are hypokinetic. The LV septum in dyssynergic.Left AtriumThe left atrium is mildly dilated (103ml). Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 55%, the RV end diastolic volume index is 74 ml/m2 (normal range 82+/-16), the RVEDV is 149 ml (normal range 142+/-31), the RV end systolic volume index is 33 ml/m2 (normal range 31+/-9), and the RVESV is 67 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. Ascending aorta at the level of the main pulmonary artery measures 42x43 mmMitral ValveThe mitral valve opens widely and there is at least mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is mildly dilated (41mm).Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Right upper PV = 22 x 20 mmRight lower PV = 14 x 20 mmLeft upper PV = 20 x 21 mmLeft lower PV = 18 x 14 mmPulmonary ArteryThe main pulmonary artery is normal in size (29 mm).Venous AnatomyThe SVC and IVC normally into the right atrium.PericardiumThere is no obvious pericardial disease.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. The left ventricle is normal in size and systolic function, the LVEF is 55%. 2. There is transmural late gadolinium enhancement at the basal lateral and infero-lateral walls. This findings could be consistent with prior myocardial infarction or alternatively suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. These segments are hypokinetic. 3. The right ventricle is normal in size and systolic function, the RVEF is 55%. 4. There is mild dilatation of the ascending aorta. See measurements above. 5. See pulmonary vein measurements above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.