39-year-old male with atrial fibrillation and left ventricular hypertrophy. MRI to evaluate possible hypertrophic cardiomyopathy. Left VentricleThe left ventricle is normal in size with hyperdynamic systolic function. There is asymmetric hypertrophy which is most pronounced at the basal inferoseptum which is ~17mm thick (IVSd). The remainder of the myocardium has normal wall thickness (PWd=9mm). The overall LV ejection fraction is 74%. The LVEDV is 179 ml (normal range 142+/-34), the LV end diastolic volume index is 83 ml/m2 (normal range: 74+/-15), the LVESV is 47 ml (normal range 47+/-19) and the LV end systolic volume index is 22 ml/m2 (normal range 25+/-9). The LV mass is 202 g (normal range 164+/-36) and the LV mass index is 94 g/m2 (normal range 85+/-15). 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.Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 57%. The RVEDV is 187 ml (normal range 142+/-31), RV end diastolic volume index is 86 ml/m2 (normal range 82+/-16), the RVESV is 80 ml (normal range 54+/-17), and the RV end systolic volume index is 37 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. There is systolic anterior motion of the mitral leaflets with associated mild mitral regurgitation and what appears to be a moderate amount of flow acceleration in the left ventricular outflow tract.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is mildly dilated.Sinus of Valsalva: 44x41mmSinotubular Junction: 31x32mmAscending Aorta: 32x31mmPulmonary 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 obvious pericardial disease.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.Asymmetric hypertrophy of the left ventricle consistent with the diagnosis of hypertrophic cardiomyopathy. The maximum wall thickness is 17 mm along the basal inferoseptum. The overall size and systolic function of the left ventricle are normal (LVEF 74%). No evidence of underlying myocardial replacement fibrosis.2.Normal right ventricular size and systolic function (RVEF 57%).3.Severe left atrial dilation.4.There is systolic anterior motion of the mitral leaflets with associated mild mitral regurgitation and what appears to be a moderate amount of flow acceleration in the left ventricular outflow tract.5.Mild dilation of the aortic root.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.