A 37 year old female with morbid obesity who had recently an episode of wide complex tachycardia while felling palpitations. The echocardiography showed normal left ventricular function. Referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 54%, the LV end diastolic volume index is 69 ml/m2 (normal range: 65+/-11), the LVEDV is 165 ml (normal range 109+/-23), the LV end systolic volume index is 32 ml/m2 (normal range 18+/-5), the LVESV is 76 ml (normal range 31+/-10), the LV mass index is 33 g/m2 (normal range 67+/-11), and the LV mass is 79 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of underlying focal replacement fibrosis or an infiltrative, or inflammatory process. Native myocardial T1 relaxation times are mildly elevated at the basal septum and within normal range throughout the remainder of the left ventricle. Increased T1 relaxation times can be seen with the presence mild interstitial fibrosis. Left AtriumThe left atrium is normal in size. The LA volume is 93 ml.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 63 ml/m2 (normal range 69+/-14), the RVEDV is 151 ml (normal range 110+/-24), the RV end systolic volume index is 31 ml/m2 (normal range 22+/-8), and the RVESV is 74 ml (normal range 35+/-13). No fatty infiltration, focal aneurysm or regional wall motion abnormality are noted.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 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 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 normal in size with normal systolic function, the LVEF is 54%. 2. There is no late gadolinium enhancement to suggest the presence of underlying myocardial scar or infiltrative/ inflammatory process. There is, however, a mild increase in native myocardial T1 relaxation time in the basal septum, which is likely due to the presence of mild interstitial myocardial fibrosis. 3. The right ventricle is normal in size with normal systolic function, the RVEF is 50%. No fatty infiltration, focal aneurysm or regional wall motion abnormality was see. No MRI findings to support the diagnosis of arrhythmogenic right ventricular dysplasia.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.