68 year old with hypertrophic cardiomyopathy presenting for cardiac function and scar evaluation. Left VentricleThe left ventricle is normal in size with normal systolic function. There is left ventricular hypertrophy that is asymmetry. The septal wall thickness is 15-16 mm while the anterior and lateral walls are 13-14mm. The overall LV ejection fraction is 65%, the LV end diastolic volume index is 92 ml/m2 (normal range: 65+/-11), the LVEDV is 177 ml (normal range 109+/-23), the LV end systolic volume index is 33 ml/m2 (normal range 18+/-5), the LVESV is 63 ml (normal range 31+/-10). There are no regional wall motion abnormalities present. There is small amount of mid myocardial late gadolinium enhancement in the basal inferior wall that suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process in a pattern that is atypical for myocardial infarction. Left AtriumThe left atrium is mild to moderately dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 59%, the RV end diastolic volume index is 61 ml/m2 (normal range 69+/-14), the RVEDV is 117 ml (normal range 110+/-24), the RV end systolic volume index is 25 ml/m2 (normal range 22+/-8), and the RVESV is 48 ml (normal range 35+/-13). 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 jet of eccentric mitral regurgitation that is at least mild. There is systolic anterior motion (SAM) seen with flow acceleration in the LVOT. 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 with a common origin to the right innominate and left common carotid (normal variant - "pseudo-bovine"). 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. Pericardial fat was seen. Extracardiac FindingsProbable left renal cysts. 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. The left ventricle is normal in size with normal systolic function. There is left ventricular hypertrophy that is asymmetry. The septal wall thickness is 15-16 mm while the anterior and lateral walls are 13-14mm. The overall LV ejection fraction is 65%.There are no regional wall motion abnormalities present. There is a small amount of mid myocardial late gadolinium enhancement in the basal inferior wall that suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process in a pattern that is atypical for myocardial infarction. 2. Asymmetric left ventricular hypertrophy with systolic anterior motion of the mitral valve with associated flow acceleration. 3. The right ventricle is normal in size and systolic function (RVEF 59%). 4. Left atrial enlargement. 