21 year old male with diagnosis of hypertrophic cardiomyopathy who presents for cardiac MRI for further evaluation of function, morphology, and fibrosis Left VentricleThe left ventricle is normal in size and systolic function. There is asymmetric hypertrophy of the left ventricle. The maximum thickness involving the basal to mid inferior and septal walls (15-16mm); the remainder of the myocardium is approximately 7-8mm thick. There is mild evidence of turbulent flow in the outflow tract secondary to systolic anterior motion of the mitral valve. The overall LV ejection fraction is 69%, the LV end diastolic volume index is 91 ml/m2 (normal range: 74+/-15), the LVEDV is 209 ml (normal range 142+/-34), the LV end systolic volume index is 29 ml/m2 (normal range 25+/-9), the LVESV is 66 ml (normal range 47+/-19), the LV mass index is 88 g/m2 (normal range 85+/-15), and the LV mass is 202 g (normal range 164+/-36). There are no regional wall motion abnormalities present on cine imaging; however, based on myocardial tagging, the hypertrophied segments have reduced myocardial deformation. There is a small amount of subtle late gadolinium enhancement involving the basal inferior and inferolateral walls to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is atypical for prior myocardial infarction. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 90 ml/m2 (normal range 82+/-16), the RVEDV is 207 ml (normal range 142+/-31), the RV end systolic volume index is 44 ml/m2 (normal range 31+/-9), and the RVESV is 102 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThere is systolic anterior motion of the anterior mitral leaflet and associated mild mitral regurgitation and 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 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 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 and systolic function (LVEF 69%). There is asymmetric hypertrophy of the left ventricle consistent with the diagnosis of hypertrophic cardiomyopathy. There is a small amount of subtle late gadolinium enhancement involving the basal inferior and inferolateral walls to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is atypical for prior myocardial infarction. 2. The right ventricle is normal in size and systolic function (RVEF 51%).3. Systolic anterior motion of the anterior mitral leaflet with mild mitral regurgitation and mild flow acceleration in the left ventricular outflow tract.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.