57 year old male with history of non-ischemic cardiomyopathy who presents for cardiac MRI to evaluate for infiltrative disease and etiology of cardiomyopathy Left VentricleThe left ventricle is severely dilated and severely reduced in systolic function. The overall LV ejection fraction is 15%, the LV end diastolic volume index is 143 ml/m2 (normal range: 74+/-15), the LVEDV is 343 ml (normal range 142+/-34), the LV end systolic volume index is 121 ml/m2 (normal range 25+/-9), the LVESV is 290 ml (normal range 47+/-19), the LV mass index is 47 g/m2 (normal range 85+/-15), and the LV mass is 112 g (normal range 164+/-36). There is global hypokinesis. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. No evidence of myocardial iron overload. No LV apical thrombus. Left AtriumThe left atrium is severely dilated. There is a possible thrombus in the left atrial appendage. Right VentricleThe right ventricle is mildly dilated and severely reduced in systolic function. The overall RV ejection fraction is 26%, the RV end diastolic volume index is 114 ml/m2 (normal range 82+/-16), the RVEDV is 274 ml (normal range 142+/-31), the RV end systolic volume index is 85 ml/m2 (normal range 31+/-9), and the RVESV is 202 ml (normal range 54+/-17).Right AtriumThe right atrium is severely dilated. There is a possible thrombus at the base of the right atrial appendage.Aortic ValveThe aortic valve opens widely and there is mild aortic regurgitation. The aortic valve is trileaflet.Mitral ValveThere is reduced opening of the mitral valve. There is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is trace pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is mildly dilated. The ascending aorta is 4.3 cm.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is moderate to severely dilated in size and measures 40mm.Venous AnatomyThe SVC is normal in size and drains normally into the right atrium. The IVC is dilated.PericardiumThere is a trivial pericardial effusion.Extracardiac FindingsThere is a moderate right pleural effusion and a trace left pleural effusion. 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 severely dilated and severely reduced in systolic function (LVEF 15%) without evidence of LV apical thrombus. 2. The right ventricle is mildly dilated and severely reduced in systolic function (RVEF 26%)3. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.4. Severe biatrial dilation with possible thrombi in both atrial appendages.5. Mild ascending aortic dilation5. Moderate to severe main pulmonary artery dilation