71 year old man with history of CAD s/p PCI to RCA x 2, referred for evaluation of possible ascending aorta dilation seen on echo. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 60%, the LV end diastolic volume index is 108 ml/m2 (normal range: 74+/-15), the LVEDV is 224 ml (normal range 142+/-34), the LV end systolic volume index is 43 ml/m2 (normal range 25+/-9), the LVESV is 90 ml (normal range 47+/-19), the LV mass index is 65 g/m2 (normal range 85+/-15), and the LV mass is 134 g (normal range 164+/-36). There are no regional wall motion abnormalities present. The late gadolinium enhancement images along the basal quarter of the left ventricle are difficult to interpret due to image artifact. The remainder of the left ventricle is free of late gadolinium enhancement suggesting no underlying myocardial fibrosis, inflammation, or infiltration.Left AtriumThe left atrium is mild to moderately dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 109 ml/m2 (normal range 82+/-16), the RVEDV is 226 ml (normal range 142+/-31), the RV end systolic volume index is 53 ml/m2 (normal range 31+/-9), and the RVESV is 110 ml (normal range 54+/-17).Right AtriumThe right atrium is mild dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is trace tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. No thoracic aortic dissection or aneurysm noted. The aortic root is mildly dilated. The dimensions are as below:Sinus of Valsalva: 40x38mmST Junction: 32x31mmAscending Aorta (5cm from AV plane): 38x39mmAortic Arch: 28x32mmDescending Aorta: 28x29mmAbdominal aorta (at renal artery) 21mmPulmonary 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 with normal systolic function. The overall LV ejection fraction is 60% without evidence of obvious underlying myocardial fibrosis, inflammation, or infiltration; however, the basal quarter of the left ventricle is not well visualized due to image artifact. 2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%.3. No thoracic aortic aneurysm or dissection. Aortic root mildly dilated. 4. Mild to moderate left atrial dilation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.