A 46 year female with history of new onset atrial fibrillation, asthma and iron deficiency anemia, a recent echocardiography showed normal left ventricular function with left atrial enlargement. Referred to cardiac MRI to rule out sarcoidosis. Left VentricleThe left ventricle is moderately dilated with low normal systolic function. The overall LV ejection fraction is 54%, the LV end diastolic volume index is 99 ml/m2 (normal range: 65+/-11), the LVEDV is 125 ml (normal range 109+/-23), the LV end systolic volume index is 46 ml/m2 (normal range 18+/-5), the LVESV is 98 ml (normal range 31+/-10), the LV mass index is 58 g/m2 (normal range 67+/-11), and the LV mass is 125 g (normal range 114+/-24). 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.No intracardiac thrombus is present.Left AtriumThe left atrium is mild to moderately dilated. The LA volume is 104 ml.Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 45%, the RV end diastolic volume index is 87 ml/m2 (normal range 69+/-14), the RVEDV is 188 ml (normal range 110+/-24), the RV end systolic volume index is 48 ml/m2 (normal range 22+/-8), and the RVESV is 103 ml (normal range 35+/-13). 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 tricuspid regurgitation which was not quantified.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. PericardiumThere is no pericardial effusion.Extracardiac FindingsOvoid nodule within the right breast medially superior to the nipple line measuring 2.0 x 2.5 cm (301/16. This is hypodense to surrounding dense breast stroma and is atypical for a cyst. Additional smaller nodules are noted in the left breast. When correlated to recent mammogram and breast ultrasound of 8/5/2015, patient has noticed nodularity in bilateral breasts for 20 years and these were concluded with high probability to be benign masses. Continued physical examination and bilateral ultrasound as per mammographic report is recommended.
1. The left ventricle is moderately dilated with low normal systolic function, the LVEF is 54%. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The left atrium is mild to moderately dilated. The LA volume is 104 ml.3. The right ventricle is normal in size with mildly reduced systolic function, the RVEF is 45%. 4. Tricuspid regurgitation is present.