68 year old with history of coronary artery disease, atrial fibrillation and recent pericarditis presenting for evaluation of chest pain. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 65%, the LV end diastolic volume index is 68 ml/m2 (normal range: 74+/-15), the LVEDV is 135 ml (normal range 142+/-34), the LV end systolic volume index is 24 ml/m2 (normal range 25+/-9), the LVESV is 48 ml (normal range 47+/-19), the LV mass index is 37 g/m2 (normal range 85+/-15), and the LV mass is 75 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is small area of atypical late gadolinium enhancement in the basal inferolateral wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. This is similar to previous exam. There is no significant diastolic septal bounce. Also, there is no exaggerated respiratory variation of the septal position.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 50%, the RV end diastolic volume index is 78 ml/m2 (normal range 82+/-16), the RVEDV is 156 ml (normal range 142+/-31), the RV end systolic volume index is 39 ml/m2 (normal range 31+/-9), and the RVESV is 78 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 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 "pseudo-bovine" branching pattern with common origin of right innominate and left common carotid arteries . The aortic root and ascending aorta is mildly dilated (ascending aorta 42 mm, SoV 39 mm).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 are normal in size and drain normally into the right atrium.PericardiumThere is a small pericardial effusion. The pericardium is mildly thickened (4-6mm). It is worst in the basal inferolateral wall. The pericardium has increased signal on T2-weighted imaging and also on late gadolinium enhancement consistent with pericarditis. 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. Mild pericardial thickening with evidence of acute/ subacute pericarditis. No clear evidence of constriction.2. Normal LV size with systolic function (LVEF 65%) with evidence of a small amount of atypical late gadolinium enhancement involving the basal inferolateral wall, which was also present on the prior study. It suggests the presence of underlying myocardial fibrosis, inflammation, or infiltration.3. Normal RV size and systolic function (RVEF 50%).4. Mild aortic root dilation. 