61 year old male with history of heart failure secondary to presumed non-ischemic cardiomyopathy, atrial fibrillation, who presents for cardiac MRI to evaluate for etiology and fibrosis. Left VentricleThe left ventricle is severely dilated with mildly reduced function. The overall LV ejection fraction is 52%, the LV end diastolic volume index is 149 ml/m2 (normal range: 74+/-15), the LVEDV is 297 ml (normal range 142+/-34), the LV end systolic volume index is 72 ml/m2 (normal range 25+/-9), the LVESV is 142 ml (normal range 47+/-19). There are no regional wall motion abnormalities present. . There is a mild mid-wall stripe of late gadolinium enhancement in the mid to basal septum, which suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern is non-specific and often seen in dilated cardiomyopathy.Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is severely dilated with normal systolic function. The overall RV ejection fraction is 54%, the RV end diastolic volume index is 156 ml/m2 (normal range 82+/-16), the RVEDV is 309 ml (normal range 142+/-31), the RV end systolic volume index is 72 ml/m2 (normal range 31+/-9), and the RVESV is 142 ml (normal range 54+/-17).Right AtriumThe right atrium is severely dilated.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 probably severe 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. IVC severely dilated.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsLarge right pleural effusion and small left pleural effusion. 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. The left ventricle is severely dilated with mildly reduced systolic function [LVEF 52%]2. The right ventricle is severely dilated with normal systolic function [RVEF 54%]3. There is a mild mid-wall stripe of late gadolinium enhancement in the mid to basal septum, which suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern is non-specific and often seen in dilated cardiomyopathy.4. Severe tricuspid regurgitation4. Severe biatrial dilationI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.