75 year old woman with LV dysfunction of unclear etiology, referred for further assessment with cardiac MRI. Left VentricleThe left ventricle is severely dilated with moderately decreased systolic function . The overall LV ejection fraction is 36%, the LV end diastolic volume index is 126 ml/m2 (normal range: 65+/-11), the LVEDV is 173 ml (normal range 109+/-23), the LV end systolic volume index is 81 ml/m2 (normal range 18+/-5), the LVESV is 111 ml (normal range 31+/-10), the LV mass index is 58 g/m2 (normal range 67+/-11), and the LV mass is 80 g (normal range 114+/-24). LV dysfunction is global with regional variation. There is a dyssynergic septum consistent with patient's underlying left bundle branch block. Single tiny patch of late gadolinium enhancement in the basal inferior wall of unclear significance. Otherwise no LGE to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 65%, the RV end diastolic volume index is 56 ml/m2 (normal range 69+/-14), the RVEDV is 77 ml (normal range 110+/-24), the RV end systolic volume index is 20 ml/m2 (normal range 22+/-8), and the RVESV is 27 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 mild-moderate mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.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 main pulmonary artery is normal in size (28mm). Venous AnatomyThe SVC has a previously placed stent present. There is a right sided catheter with tip terminating in the SVC-RA junction. The IVC is normal in size and drains 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 severely dilated with moderately decreased systolic function . The overall LV ejection fraction is 36%. LV dysfunction is global with regional variation. There is a single tiny patch of late gadolinium enhancement in the basal inferior wall of unclear significance. Otherwise no LGE to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 65%.3. The left atrium is moderately dilated. 4. There is mild-moderate mitral regurgitation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.