69 year old female with a history of apical hypertrophy, question of hypertrophic cardiomyopathy who is referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is mildly dilated and normal systolic function. The overall LV ejection fraction is 70%, the LV end diastolic volume index is 103 ml/m2 (normal range: 65+/-11), the LVEDV is 151 ml (normal range 109+/-23), the LV end systolic volume index is 31 ml/m2 (normal range 18+/-5), the LVESV is 45 ml (normal range 31+/-10). 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. There is apical hypertrophy, however the hypertrophy is not confined to the apical segments. The mid anterior and anteroseptal walls are hypertrophied: lateral wall 10 mm, mid septum/anteroseptum 19-20.Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 62%, the RV end diastolic volume index is 92 ml/m2 (normal range 69+/-14), the RVEDV is 135 ml (normal range 110+/-24), the RV end systolic volume index is 35 ml/m2 (normal range 22+/-8), and the RVESV is 51 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is mild aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is moderate mitral regurgitation. Pulmonic ValveNot well visualized.Tricuspid ValveThe tricuspid valve opens widely. There is at least mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a pseudo-bovine great vessel pattern. There is aneurysmal dilation of the brachiocephalic vessel (above and beyond the pseudo bovine pattern). The aortic root is dilated (37x40 mm at Sinus of Valsalva)Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is severely dilated. Venous AnatomyThe SVC and IVC are normal in size and drain 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 mildly dilated with normal systolic function (LVEF 70%).2. The right ventricle is normal in size and systolic function (RVEF 62%). 3. There is apical hypertrophy, however the hypertrophy is not confined to the apical segments. The mid anterior and anteroseptal walls are hypertrophied.4. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.5. The main pulmonary artery is severely dilated. 6. There is a left sided aortic arch with a pseudo-bovine great vessel pattern. There is aneurysmal dilation of the brachiocephalic vessel (above and beyond the pseudo bovine pattern). The aortic root is dilated (37x40 mm at Sinus of Valsalva)I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.