23 year old male with history of hypertrophic cardiomyopathy with fibrosis presenting for repeat cardiac evaluation. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 60%, the LV end diastolic volume index is 71 ml/m2 (normal range: 74+/-15), the LVEDV is 147 ml (normal range 142+/-34), the LV end systolic volume index is 29 ml/m2 (normal range 25+/-9), the LVESV is 59 ml (normal range 47+/-19), the LV mass index is 55 g/m2 (normal range 85+/-15), and the LV mass is 115 g (normal range 164+/-36). There are no regional wall motion abnormalities present. In the mid inferoseptal wall, near the right ventricular insertion point, there are patchy areas of late gadolinium enhancement corresponding to the thickest area of the myocardium. The remaining myocardium appears to be free of LGE. The thickest area of myocardium measures 16 mm in the mid infero-septal wall. The hypertrophy is primarily in the inferoseptal wall. There is no systolic anterior motion of the mitral valve seen. Left AtriumThe left atrium is normal in size. 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 70 ml/m2 (normal range 82+/-16), the RVEDV is 146 ml (normal range 142+/-31), the RV end systolic volume index is 34 ml/m2 (normal range 31+/-9), and the RVESV is 71 ml (normal range 54+/-17).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 mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild 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 (main PA 27 mm).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 normal in size with normal systolic function (LVEF 60%). 2. The right ventricle is normal in size with normal systolic function (RVEF 51%)3. Findings consistent with hypertrophic cardiomyopathy with maximal septal thickness of 16 mm in mid inferoseptal wall corresponding to an area of patchy late gadolinium enhancement. There is LGE at the RV insertion points. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.