63 year old male with new onset congestive heart failure, recent chest pain and dyspnea. Evaluation for cardiomyopathy. Left VentricleThe left ventricle is severely dilated with severely reduced systolic function. The overall LV ejection fraction is 26%. The LVEDV is 304 ml (normal range 142+/-34), the LV end diastolic volume index is 136 ml/m2 (normal range: 74+/-15), the LVESV is 225 ml (normal range 47+/-19) and the LV end systolic volume index is 101 ml/m2 (normal range 25+/-9). The LV mass is 227 g (normal range 164+/-36) and the LV mass index is 102 g/m2 (normal range 85+/-15). There is global hypokinesis with regional variation. There is a prominent mid-wall stripe of late gadolinium enhancement involving the basal and mid anteroseptum and inferoseptum. This pattern is atypical for prior myocardial infarction and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process.There is no myocardial iron overload. There is no LV thrombus. Left AtriumThe left atrium is severely enlarged. Right VentricleThe right ventricle is normal in size. The overall RV ejection fraction is 50%. The RVEDV is 170 ml (normal range 142+/-31), RV end diastolic volume index is 76 ml/m2 (normal range 82+/-16), the RVESV is 85 ml (normal range 54+/-17), and the RV end systolic volume index is 38 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve is trileaflet, 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 mildly dilated. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsA large lymph node is located in the left mediastinum, next to main pulmonary artery. 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. Severely enlarged left ventricle with severely reduced systolic function (LVEF 26%) with evidence of a prominent mid-wall stripe of late gadolinium enhancement involving the basal and mid anteroseptum and inferoseptum. This pattern is atypical for prior myocardial infarction and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. Normal right ventricular size and systolic function (RVEF 50%).3. Severe left atrial dilation.4. Mild dilation of main pulmonary artery.5. See extra-cardiac findings. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.