A 16 year old female with syncope and echocardiographic findings of suspected interatrial shunt. Also noted to have right ventricle enlargement with mildly reduced systolic function. Referred for cardiac MRI to further evaluate these findings Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 56%, the LV end diastolic volume index is 87 ml/m2 (normal range: 65+/-11), the LVEDV is 148 ml (normal range 109+/-23), the LV end systolic volume index is 38 ml/m2 (normal range 18+/-5), the LVESV is 66 ml (normal range 31+/-10), the LV mass index is 36 g/m2 (normal range 67+/-11), and the LV mass is 62 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.Left AtriumThe left atrium is normal in size. The LA volume is 54 ml. There is a small PFO or ASD noted with predominantly left-to-right shunting with saturation band technique. Right VentricleThe right ventricle is normal in size with low normal systolic function. The overall RV ejection fraction is 47%, the RV end diastolic volume index is 91 ml/m2 (normal range 69+/-14), the RVEDV is 155 ml (normal range 110+/-24), the RV end systolic volume index is 48 ml/m2 (normal range 22+/-8), and the RVESV is 83 ml (normal range 35+/-13). No RV wall motion abnormalities or sacculations/aneurysms noted. Indexed RVEDV meets pat of the minor criteria for ARVC.Right AtriumThe right atrium is normal in size. The RA volume is 76 ml.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 trace 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. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. Coronary arteriesThe coronary arteries have normal origin.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 normal in size and systolic function, the LVEF is 56%. 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.2. The right ventricle is normal in size with low systolic function, the RVEF is 47%. No wall motion abnormalities noted of the RV wall in this study. Indexed RVEDV was 91 mL/m2 meeting part of the one of the minor criteria for ARVC. 3. Small PFO/ASD noted. Qp:Qs not calculated.4. Normal origins of the coronary arteries.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.