16 year old female with a history of chest pain of unclear etiology referred for cardiac MRI for further evaluation. Coronary Artery OriginNormal origin of right and left coronary arteries from the sinuses of Valsalva. Left VentricleThe left ventricle is mildly dilated with systolic function. The overall LV ejection fraction is 58%, the LV end diastolic volume index is 90 ml/m2 (normal range: 65+/-11), the LVEDV is 157 ml (normal range 109+/-23), the LV end systolic volume index is 38 ml/m2 (normal range 18+/-5), the LVESV is 66 ml (normal range 31+/-10), the LV mass index is 23 g/m2 (normal range 67+/-11), and the LV mass is 40 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. Pre-contrast native myocardial T1 relaxation times are normal (1070 ms). No evidence of myocardial iron overload. There is evidence of a spontaneously "closed/ healed" apical muscular ventricular septal defect. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 109 ml/m2 (normal range 69+/-14), the RVEDV is 190 ml (normal range 110+/-24), the RV end systolic volume index is 54 ml/m2 (normal range 22+/-8), and the RVESV is 94 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 no significant 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. 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. Normal origin of right and left coronary arteries from the sinuses of Valsalva. 2. The left ventricle is mildly dilated with systolic function (LVEF 58%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration.3. The right ventricle is mildly dilated with normal systolic function (RVEF 51%).4. There is evidence of a spontaneously "closed/ healed" apical muscular ventricular septal defect. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.