57 year old woman with HIV and NSVT, prior syncopal episode, referred for evaluation of underlying structural abnormalities or fibrosis. Left VentricleThe left ventricle is normal in size with hyperdynamic systolic function. The overall LV ejection fraction is 73%, the LV end diastolic volume index is 85 ml/m2 (normal range: 65+/-11), the LVEDV is 153 ml (normal range 109+/-23), the LV end systolic volume index is 23 ml/m2 (normal range 18+/-5), the LVESV is 41 ml (normal range 31+/-10), the LV mass index is 78 g/m2 (normal range 67+/-11), and the LV mass is 140 g (normal range 114+/-24). There is mild concentric left ventricular hypertrophy. 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. No evidence of myocardial iron overload. The native myocardial T1 time is borderline elevated (1,088ms).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 60%, the RV end diastolic volume index is 96 ml/m2 (normal range 69+/-14), the RVEDV is 175 ml (normal range 110+/-24), the RV end systolic volume index is 39 ml/m2 (normal range 22+/-8), and the RVESV is 70 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly 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. There is mild systolic anterior motion of the mitral leaflets with evidence of mild flow acceleration in the left ventricular outflow tract. Pulmonic ValveThe pulmonic valve opens widely. There is mild pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is moderate 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 mild-moderately dilated. 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. The left ventricle is normal in size with hyperdynamic systolic function. The overall LV ejection fraction is 73%. There is mild concentric left ventricular hypertrophy without evidence of underlying replacement myocardial fibrosis, inflammation, or infiltration. No evidence of myocardial iron overload. The native myocardial T1 time is borderline elevated suggesting the presence of early interstitial fibrosis, likely related to the left ventricular hypertrophy. 2. The right ventricle is normal in size with normal systolic function . The overall RV ejection fraction is 60%.3. There is mild systolic anterior motion of the mitral leaflets with evidence of mild flow acceleration in the left ventricular outflow tract. 4. Mild to moderate dilation of the main pulmonary artery.5. Mild right atrial dilation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.