62 year old male, status post lung transplant, need for evaluation for pericardial disease/constriction. Left VentricleThe left ventricle is normal in size and global function. The overall LV ejection fraction is 58%. The LVEDV is 59 ml (normal range 142+/-34), the LV end diastolic volume index is 30 ml/m2 (normal range: 74+/-15), the LVESV is 25 ml (normal range 47+/-19) and the LV end systolic volume index is 12 ml/m2 (normal range 25+/-9). 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.There is presence of interventricular dependence with paradoxical septal motion, this appears to be most prominent during inspiration. The native T1 myocardial relaxation time is approximately [1010]ms. These values are [within normal limits], suggestive of [no]underlying diffuse fibrosis or infiltration.Left AtriumThe left atrium is dilated. Right VentricleThe right ventricle is normal in size and decreased in function. The overall RV ejection fraction is 30%. The RVEDV is 83 ml (normal range 142+/-31), RV end diastolic volume index is 42 ml/m2 (normal range 82+/-16), the RVESV is 58 ml (normal range 54+/-17), and the RV end systolic volume index is 29 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is dilated.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 trace 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 a large circumferential pericardial effusion.Extracardiac FindingsLarge bilateral pleural effusions. Ascites is present. 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. Left ventricle is normal in size and global function. The overall LV ejection fraction is 58%. 2 There is interventricular dependence with paradoxical septal motion. This may be related to RV pressure overload, however there appears to have a respirophasic component (most prominent with inspiration) which suggests the pericardial process is contributing, with the significant pericardial effusion it is difficult to isolate the contribution from any possible pericardial constriction.2. Right ventricle is normal in size and decreased in function. The overall RV ejection fraction is 30%.3. There is a large circumferential pericardial effusion. The pericardium thickness is not grossly thickened.4. See extracardiac findingsI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.