a 36 year old male with hypertension, atrial fibrillation, gout and heart failure suspected to be non-ischemic. The patient is now hospitalized due to decompensated heart failure and referred to cardiac MRI for further evaluation of function and etiology. Left VentricleThe left ventricle is severe dilated with significant systolic dysfunction. The lateral wall demonstrates severe hypokinesis with akinesia of the sepum, inferior and anterior walls.The overall LV ejection fraction is 13%, the LV end diastolic volume index is 259 ml/m2 (normal range: 74+/-15), the LVEDV is 584 ml (normal range 142+/-34), the LV end systolic volume index is 224 ml/m2 (normal range 25+/-9), the LVESV is 506 ml (normal range 47+/-19), the LV mass index is 82 g/m2 (normal range 85+/-15), and the LV mass is 185 g (normal range 164+/-36). The myocardium is globally thinned. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.No LV cavity thrombus. No iron overload. No findings to suggest amyloid in the myocardium. Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is severely dilated with severe systolic dysfunction. The overall RV ejection fraction is 20%, the RV end diastolic volume index is 172 ml/m2 (normal range 82+/-16), the RVEDV is 387 ml (normal range 142+/-31), the RV end systolic volume index is 137 ml/m2 (normal range 31+/-9), and the RVESV is 309 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. Visually, there is moderate to severe mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. Visually, 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 normal in size.Venous AnatomyThe SVC drains normally into the right atrium. There is azygous continuation of the IVC.PericardiumThere is trace pericardial effusion.
1. The left ventricle is severe dilated with extreme systolic dysfunction, the LVEF is 13%. The myocardium is globally thinned. There is global hypo/akinesis with regional wall motion variation. 2. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. No LV cavity thrombus. No iron overload. No findings to suggest amyloid in the myocardium. 3. The right ventricle is severely dilated with severe systolic dysfunction, the RVEF is 20%. 4. The left and right atrium are severely dilated. 5. Azygous continuation of the IVC.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.