Mr. Brown is a 65 year old male with a history of Philadelphia chromosome positive CML on Gleevec, papillary thyroid cancer s/p partial thyroidectomy, OSA, with complaints of palpitations and irregular heart rate. Left VentricleThe left ventricle is moderately dilated with mild to moderately reduced systolic function. The overall LV ejection fraction is 43%, the LV end diastolic volume index is 130 ml/m2 (normal range: 74+/-15), the LVEDV is 306 ml (normal range 142+/-34), the LV end systolic volume index is 73 ml/m2 (normal range 25+/-9), the LVESV is 173 ml (normal range 47+/-19). LV dysfunction is global. There are several small non-contiguous patches of nontransmural late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process in the mid lateral, inferior and septal walls that is atypical for myocardial infarction. Native T1 time is approximately 1080 ms. Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 60%, the RV end diastolic volume index is 86 ml/m2 (normal range 82+/-16), the RVEDV is 204 ml (normal range 142+/-31), the RV end systolic volume index is 34 ml/m2 (normal range 31+/-9), and the RVESV is 80 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately 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 no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a common right innominate and left common carotid brachiocephalic branching pattern (normal variant). The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is moderately dilated (33 mm x 32 mm).Venous AnatomyThe SVC and IVC 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 moderately dilated with mild to moderately reduced systolic function. There are LV dysfunction is global. There are several small non-contiguous patches of nontransmural late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process in the mid lateral, inferior and septal walls that is atypical for myocardial infarction. Native T1 time is approximately 1080 ms. 2. The right ventricle is normal in size and systolic function. The overall RV ejection fraction is 60%.3. Biatrial enlargement. 4. Dilated pulmonary artery. 