48 year old with history of constrictive pericarditis with history of pericardial stripping presenting for evaluation after abnormal finding on echocardiogram. Left VentricleThe left ventricle is mildly dilated with normal systolic function. The overall LV ejection fraction is 56%, the LV end diastolic volume index is 109 ml/m2 (normal range: 74+/-15), the LVEDV is 202 ml (normal range 142+/-34), the LV end systolic volume index is 48 ml/m2 (normal range 25+/-9), the LVESV is 89 ml (normal range 47+/-19), the LV mass index is 49 g/m2 (normal range 85+/-15), and the LV mass is 91 g (normal range 164+/-36). 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. Native T1 times are normal at 970 ms. No evidence of extrinsic compression of the left ventricle. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is mildly dilated in size with normal systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 124 ml/m2 (normal range 82+/-16), the RVEDV is 228 ml (normal range 142+/-31), the RV end systolic volume index is 59 ml/m2 (normal range 31+/-9), and the RVESV is 108 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 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.PericardiumThe pericardium around the mid-ventricle to apex is not well seen. The pericardium is mildly thickened circumferentially around the basal to mid ventricle. There is minimal increase in pericardial T2-signal. There is mild late gadolinium enhancement of the pericardium. These findings are more suggestive of pericardial fibrosis rather than overt pericardial inflammation. Based on real-time cine image, there is mild respiratory variation in septal position, which is improved from before. There is no overt evidence of pericardial tethering.Extracardiac FindingsSternal wires 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. No evidence of extrinsic compression of the heart. 2. The pericardium around the mid-ventricle to apex is not well seen. The pericardium is mildly thickened circumferentially around the basal to mid ventricle. There is minimal increase in pericardial T2-signal. There is mild late gadolinium enhancement of the pericardium. These findings are more suggestive of pericardial fibrosis rather than overt pericardial inflammation. Based on real-time cine image, there is mild respiratory variation in septal position, which is improved from before. There is no overt evidence of pericardial tethering.3. Mild left ventricular dilation with normal systolic function (LVEF 56%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration.4. Mild right ventricular dilation with normal systolic function (RVEF 52%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.