A 35 year old male with hypertension, systolic aortic murmur, alcohol abuse. Noted to have irregular hear beats, frequent PVC's on holter, a recent echocardiography showed left ventricular ejection fraction of 35-40%. Referred to cardiac MRI for further evaluation Left VentricleThe left ventricle is mildly dilated with moderately reduced systolic function. The overall LV ejection fraction is 36%, the LV end diastolic volume index is 115 ml/m2 (normal range: 74+/-15), the LVEDV is 242 ml (normal range 142+/-34), the LV end systolic volume index is 72 ml/m2 (normal range 25+/-9), the LVESV is 152 ml (normal range 47+/-19), the LV mass index is 55 g/m2 (normal range 85+/-15), and the LV mass is 116 g (normal range 164+/-36). There is global hypokinesis with regional variation. Considerable breathing artifact on short axis views reducing the diagnostic accuracy of these views, however there is no evidence of late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process on long axis views or on post contrast short axis T1 views. T2-weighted images showed no signs of active inflammation. Normal native T1-times. No intracavitary thrombus.Left AtriumThe left atrium is normal in size (79ml). Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 81 ml/m2 (normal range 82+/-16), the RVEDV is 171 ml (normal range 142+/-31), the RV end systolic volume index is 40 ml/m2 (normal range 31+/-9), and the RVESV is 84 ml (normal range 54+/-17).No evidence of myocardial fatty infiltration. No regional wall motion abnormalities or aneurysms in the RV free wall. Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely, is trileaflet and there is no significant aortic regurgitation or flow acceleration.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 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 mildly dilated with moderately reduced systolic function, the LVEF is 36%. There is global hypokinesis with regional variation. 2. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process based on long axis views and post contrast short axis T1 views.3. The right ventricle is normal in size with normal systolic function, the RVEF is 51%. No evidence of myocardial fatty infiltration. No regional wall motion abnormalities or aneurysms. 4. The aortic valve opens widely, is trileaflet and there is no significant aortic regurgitation or flow acceleration.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.