24 year old male with severe acne, newly heard murmur, decreased RV function on TTE. Referred for cardiac MRI to rule out ARVC. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 56%. The LVEDV is 187 ml (normal range 142+/-34), the LV end diastolic volume index is 104 ml/m2 (normal range: 74+/-15), the LVESV is 83 ml (normal range 47+/-19) and the LV end systolic volume index is 46 ml/m2 (normal range 25+/-9). The LV mass is 73 g (normal range 164+/-36) and the LV mass index is 41 g/m2 (normal range 85+/-15). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is mildly dilated with mildly depressed systolic function. It is compressed by a lower sternal pectus excavatum deformity accounting for its unusual shape. The overall RV ejection fraction is 45%. The RVEDV is 217 ml (normal range 142+/-31), RV end diastolic volume index is 120 ml/m2 (normal range 82+/-16), the RVESV is 119 ml (normal range 54+/-17), and the RV end systolic volume index is 66 ml/m2 (normal range 31+/-9).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 FindingsThere is a pectus excavatum. 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 LV size and systolic function (LVEF 56%).2.No late gadolinium enhancement. 3.Mildly dilated RV with mildly depressed systolic function (RVEF 45%). 4.There is a pectus excavatum deformity that compresses the right ventricle at the level of the body. This accounts for the unusually shaped RV. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.