39 year old woman with palpitations, near syncope, referred for evaluation of underlying infiltrative or inflammatory disease. 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 93 ml/m2 (normal range: 65+/-11), the LVEDV is 224 ml (normal range 109+/-23), the LV end systolic volume index is 41 ml/m2 (normal range 18+/-5), the LVESV is 98 ml (normal range 31+/-10), the LV mass index is 50 g/m2 (normal range 67+/-11), and the LV mass is 118 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is a small amount of epicardial late gadolinium enhancement involving the basal inferior and inferolateral walls to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is atypical for prior myocardial infarction. The presence of late gadolinium enhancement in this region has been described in individuals with mitral valve prolapse. No evidence of myocardial iron overload. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 83 ml/m2 (normal range 69+/-14), the RVEDV is 199 ml (normal range 110+/-24), the RV end systolic volume index is 40 ml/m2 (normal range 22+/-8), and the RVESV is 95 ml (normal range 35+/-13). There are no RV regional wall motion abnormalities.Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThere is bileaflet mitral valve prolapse with mild 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 mildly 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. The overall LV ejection fraction is 56%. There is a small amount of epicardial late gadolinium enhancement involving the basal inferior and inferolateral walls to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is atypical for prior myocardial infarction. The presence of late gadolinium enhancement in this region has been described in individuals with mitral valve prolapse.2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 52%.3. Mild dilation of the main pulmonary artery.4. Bileaflet mitral valve prolapse with mild mitral regurgitation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.