46 year old man with a family history of sudden cardiac death referred to rule out hypertrophic cardiomyopathy. Left VentricleThe left ventricle is normal in size with normal systolic function. There is asymmetric thickening of the left ventricular wall. The basal anteroseptum is mildly hypertrophied (IVSd=12mm). The remainder of the myocardium is normal wall thickness (PWd=6mm). The overall LV ejection fraction is 55%, the LV end diastolic volume index is 103 ml/m2 (normal range: 74+/-15), the LVEDV is 217 ml (normal range 142+/-34), the LV end systolic volume index is 46 ml/m2 (normal range 25+/-9), the LVESV is 97 ml (normal range 47+/-19), the LV mass index is 87 g/m2 (normal range 85+/-15), and the LV mass is 183 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is epicardial late gadolinium enhancement involving the basal inferolateral wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is atypical for prior myocardial infarction. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 63%, the RV end diastolic volume index is 93 ml/m2 (normal range 82+/-16), the RVEDV is 195 ml (normal range 142+/-31), the RV end systolic volume index is 35 ml/m2 (normal range 31+/-9), and the RVESV is 73 ml (normal range 54+/-17).Right AtriumThe right atrium is norma 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 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.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThere is a mild hiatal hernia. This 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. Normal left ventricular size and systolic function (LVEF 55%). There is asymmetric thickening of the left ventricular wall; however, strict criteria for the diagnosis of hypertrophic cardiomyopathy are not met. 2. There is a small amount of epicardial late gadolinium enhancement involving the basal inferolateral wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is atypical for prior myocardial infarction. 3. Normal right ventricular size and systolic function (RVEF 63%). 