Ms. Warmack is a 61-year-old woman with hypertension, alcoholic cirrhosis, bipolar disorder, chronic mastoiditis, and history of presumed heart failure presenting for cardiac evaluation Left VentricleThe left ventricle is mildly to moderately dilated with severely reduced systolic function. The overall LV ejection fraction is 30%, the LV end diastolic volume index is 95 ml/m2 (normal range: 65+/-11), the LVEDV is 169 ml (normal range 109+/-23), the LV end systolic volume index is 67 ml/m2 (normal range 18+/-5), the LVESV is 119 ml (normal range 31+/-10), the LV mass index is 46 g/m2 (normal range 67+/-11), and the LV mass is 81 g (normal range 114+/-24). The systolic dysfunction is global. There is significant motion artifact throughout the study. However, no abnormal enhancement is present.No intracardiac thrombus. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with severely reduced systolic . The overall RV ejection fraction is 36%, the RV end diastolic volume index is 80 ml/m2 (normal range 69+/-14), the RVEDV is 142 ml (normal range 110+/-24), the RV end systolic volume index is 51 ml/m2 (normal range 22+/-8), and the RVESV is 91 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 visibly mild mitral regurgitation. Dedicated imaging was not performed.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 common origin of the right innominate and left common carotid artery. 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 are normal in size and drain normally into the right atrium. PericardiumThere is no pericardial effusion.Extracardiac FindingsThere are multiple T2 hyperintense lesions in the liver, the largest is 4.0 x 5.5 cm. These are incompletely characterized and can be further evaluated with hepatic MRI. Considerations include cysts and hemangiomas.
1. LV ejection fraction is 30%. No abnormal enhancement.2. RV ejection fraction is 36%.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.