A 68 year old male with history of hypertrophic cardiomyopathy, Crohn's disease, remote colon and bladder cancer status post resection, nephrolithiasis. Referred to cardiac MRI to assess the cardiomyopathy. Left VentricleThe left ventricle is normal in size with hyperdynamic systolic function. The overall LV ejection fraction is 70%, the LV end diastolic volume index is 76 ml/m2 (normal range: 74+/-15), the LVEDV is 152 ml (normal range 142+/-34), the LV end systolic volume index is 23 ml/m2 (normal range 25+/-9), the LVESV is 45 ml (normal range 47+/-19). There is concentric hypertrophy with increased myocardial mass. At end diastole, the antero septum is 18mm. The inferolateral wall is 16mm. There is focal, intermediate signal enhancement at the mid myocardial insertion points of the interventricular septum. There are no cardiac MRI findings to suspect cardiac amyloidosis.No intracardiac thrombus.Left AtriumThe left atrium is dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 64%, the RV end diastolic volume index is 57 ml/m2 (normal range 82+/-16), the RVEDV is 113 ml (normal range 142+/-31), the RV end systolic volume index is 20 ml/m2 (normal range 31+/-9), and the RVESV is 40 ml (normal range 54+/-17).Right AtriumThe right atrium is normal size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mitral regurgitation. This was not quantified but is estimated to be at least moderate in the presence of left atrial chamber dilation. Associated moderate to severe systolic anterior motion of the anterior leaflet of the mitral valve with acceleration of antegrade flow at the subvalvular left ventricular outflow tract.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 thoracic aorta 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 a trace pericardial effusion.Extracardiac FindingsLeft renal atrophy with lesions previously characterized as likely cysts. These are incompletely characterized on this exam.
1. The left ventricle is normal in size with hyperdynamic systolic function, the LVEF is 70%. There is hypertrophy with increased mass. Mid myocardial enhancement at RV insertion site at interventricular septum. SAM with MR and accelerated flow in the subvalvular outflow tract. Constellation of findings are compatible with hypertrophic cardiomyopathy.2. The right ventricle is normal in size with normal systolic function, the RVEF is 64%. 