15 year old woman with pulmonic stenosis s/p angioplasty who now has significant pulmonic valve regurgitation. She is referred for assessment of her RV size and function as part of a clinical study. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 67%, the LV end diastolic volume index is 50 ml/m2 (normal range: 65+/-11), the LVEDV is 107 ml (normal range 109+/-23), the LV end systolic volume index is 16 ml/m2 (normal range 18+/-5), the LVESV is 35 ml (normal range 31+/-10), the LV mass index is 33 g/m2 (normal range 67+/-11), and the LV mass is 70 g (normal range 114+/-24). There are no regional wall motion abnormalities present. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is upper-normal size when adjusted for body surface area; however, when compared to the LV it is nearly twice as large. There is normal RV systolic function. The overall RV ejection fraction is 54%, the RV end diastolic volume index is 96 ml/m2 (normal range 69+/-14), the RVEDV is 205 ml (normal range 110+/-24), the RV end systolic volume index is 44 ml/m2 (normal range 22+/-8), and the RVESV is 94 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. 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 is bicuspid and opens widely. There is moderate to severe pulmonary regurgitation. Regurgitant fraction is 37% and regurgitant volume 42ml.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 normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe distal main pulmonary artery is mildly dilated and very distensible. During diastole it is mildly dilated (28mm) and during systole it is 38mm.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsPossible thyroid enlargement, recommend correlation with physical exam. 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. Normal LV size and systolic function (LVEF 67%).2. The right ventricle is upper-normal size when adjusted for body surface area; however, when compared to the LV it is nearly twice as large. There is normal RV systolic function (RVEF 54%).3. Bicuspid pulmonic valve with normal leaflet excursion but moderate to severe pulmonic regurgitation.4. Mild dilation of the distal main pulmonary artery.5. See extra-cardiac findings. 