71 year old man with previous wide complex tachycardia who underwent EP ablation, with right atrial enlargement noted during procedure, now referred for cardiac MRI. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 87 ml/m2 (normal range: 74+/-15), the LVEDV is 181 ml (normal range 142+/-34), the LV end systolic volume index is 39 ml/m2 (normal range 25+/-9), the LVESV is 81 ml (normal range 47+/-19), the LV mass index is 34 g/m2 (normal range 85+/-15), and the LV mass is 71 g (normal range 164+/-36). There is a small area of late gadolinium enhancement in the basal inferolateral which is nearly transmural, and suggestive of prior infarction. There are no wall motion abnormalities. There is no evidence of myocardial iron overload or intracardiac thrombus.Left AtriumThe left atrium is moderately enlarged. The interatrial septum appears aneurysmal.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 56%, the RV end diastolic volume index is 87 ml/m2 (normal range 82+/-16), the RVEDV is 181 ml (normal range 142+/-31), the RV end systolic volume index is 38 ml/m2 (normal range 31+/-9), and the RVESV is 80 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly enlarged.Aortic ValveThe aortic valve is trileaflet. The aortic valve opens widely and there is mild aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is trivial 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 normal brachiocephalic branching pattern. The aortic root is normal in size. The thoracic aorta is tortuous.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 pericardial effusion.Extracardiac FindingsDextroscoliosis. Hepatic and renal cysts.
1. Normal size LV with normal systolic function (EF 55%).2. Small area of late gadolinium enhancement in the basal inferolateral wall which is transmural and consistent with infarction.3. Normal size RV with normal systolic function (EF =56%).4. Biatrial dilation. 5. Mild aortic regurgitation. 