A 53 year old female with history of breast cancer treated with radiotherapy and chemotherapy, now on Herceptin. A recent echocardiography showed a decreased in left ventricular ejection fraction from normal to 42%. Referred to cardiac MRI for further evaluation Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 91 ml/m2 (normal range: 65+/-11), the LVEDV is 193 ml (normal range 109+/-23), the LV end systolic volume index is 50 ml/m2 (normal range 18+/-5), the LVESV is 106 ml (normal range 31+/-10), the LV mass index is 54 g/m2 (normal range 67+/-11), and the LV mass is 114 g (normal range 114+/-24). There is mild global hypokinesis. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.No iron overload.No intracavitary thrombus.Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 61%, the RV end diastolic volume index is 73 ml/m2 (normal range 69+/-14), the RVEDV is 155 ml (normal range 110+/-24), the RV end systolic volume index is 29 ml/m2 (normal range 22+/-8), and the RVESV is 61 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant 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. 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. A catheter was seen in the SVC coming from a port-a-cath in the right chest. PericardiumThere is no pericardial effusion.Extracardiac FindingsS/p left mastectomy. 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 mildly dilated with mildly reduced systolic function, the LVEF is 45%. 2. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. The right ventricle is normal in size with normal systolic function, the RVEF is 61%.4. The left atrium is mildly dilated. 5. A catheter was seen in the SVC coming from a port-a-cath in the right chest. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.