53 year old woman with new diagnosis of heart failure, referred for cardiac MRI for further evaluation of underlying etiology and viability. Left VentricleThe left ventricle is moderate-severely dilated with severely reduced systolic function. The overall LV ejection fraction is 24%, the LV end diastolic volume index is 112 ml/m2 (normal range: 65+/-11), the LVEDV is 225 ml (normal range 109+/-23), the LV end systolic volume index is 85 ml/m2 (normal range 18+/-5), the LVESV is 171 ml (normal range 31+/-10), the LV mass index is 91 g/m2 (normal range 67+/-11), and the LV mass is 183 g (normal range 114+/-24). These is septal dyssynchrony. LV dysfunction is global with regional variation. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The entire myocardium is viable. Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 47%, the RV end diastolic volume index is 61 ml/m2 (normal range 69+/-14), the RVEDV is 122 ml (normal range 110+/-24), the RV end systolic volume index is 32 ml/m2 (normal range 22+/-8), and the RVESV is 64 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. There is trace mitral regurgitation. Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild-moderate tricuspid regurgitation.AortaThere is a left sided aortic arch with what appears to be a psuedo-bovine branching pattern (left internal carotid and left subclavian artery arise from a common origin), however this evaluation is limited by image quality in this region. 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. The left ventricle is moderate-severely dilated with severely reduced systolic function. The overall LV ejection fraction is 24%. LV dysfunction is global with regional variation. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The entire myocardium is viable.2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 47%.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.