59 year old male with new onset atrial fibrillation and heart failure. Left VentricleThe left ventricle is severely dilated with severely reduced systolic function. The overall LV ejection fraction is 24%, the LV end diastolic volume index is 149 ml/m2 (normal range: 74+/-15), the LVEDV is 336 ml (normal range 142+/-34), the LV end systolic volume index is 114 ml/m2 (normal range 25+/-9), the LVESV is 257 ml (normal range 47+/-19), the LV mass index is 67 g/m2 (normal range 85+/-15), and the LV mass is 151 g (normal range 164+/-36). The LV dysfunction is global. There is a small subendocardial area of late gadolinium enhancement in the basal anteroseptum suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process. This would fit the pattern of prior myocardial infarction, however the location is atypical. Left AtriumThe left atrium is severely enlarged. Right VentricleThe right ventricle is normal in size with moderate-severely reduced systolic function. The overall RV ejection fraction is 30%, the RV end diastolic volume index is 107 ml/m2 (normal range 82+/-16), the RVEDV is 242 ml (normal range 142+/-31), the RV end systolic volume index is 75 ml/m2 (normal range 31+/-9), and the RVESV is 170 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is trace significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is at least mild-moderate mitral regurgitation.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 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 are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThere is bilateral interstitial changes throughout lung fields. 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 severely reduced systolic function. The overall LV ejection fraction is 24% The LV dysfunction is global. There is a small subendocardial area of late gadolinium enhancement in the basal anteroseptum suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process. This would fit the pattern of prior myocardial infarction, however the location is atypical. 2. The right ventricle is normal in size with moderate-severely reduced systolic function (RVEF 30%)3. At least mild to moderate mitral regurgitation. 4. Severely dilated left atrium. 5. See extracardiac findingsI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.