History of myocarditis in 2/2015, repeat at 4 months to evaluate function and delayed gadolinium enhancement Left VentricleThe left ventricle is normal in size. The contractility has slightly improved with the overall LV ejection fraction equal to 55%, as compared to 53% on the prior exam. The LV end diastolic volume index is 68 ml/m2 (normal range: 74+/-15), the LVEDV is 153 ml (normal range 142+/-34), the LV end systolic volume index is 30 ml/m2 (normal range 25+/-9), the LVESV is 68 ml (normal range 47+/-19), the LV mass index is 56 g/m2 (normal range 85+/-15), and the LV mass is 124 g (normal range 164+/-36). There are no regional wall motion abnormalities present. Using similar dose of MultiHance, the enhancement of the left ventricular myocardium is reduced in extent. It is again noted in an epicardial distribution at the mid inferolateral and apical lateral wall. A thin rim of epicardial enhancement at the mid anterolateral wall is again noted. No new enhancement is identified.No intracardiac thrombus is present.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 88 ml/m2 (normal range 82+/-16), the RVEDV is 197 ml (normal range 142+/-31), the RV end systolic volume index is 42 ml/m2 (normal range 31+/-9), and the RVESV is 94 ml (normal range 54+/-17). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely. There is no significant dephasing inferior to the aortic valve to suggest significant aortic regurgitation. Dedicated through plane imaging of the aortic valve was not performed.Mitral ValveThe mitral valve opens widely. There is no significant mitral regurgitation. Dedicated through plane imaging of the mitral valve was not performed.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation visualized. Dedicated through plane imaging of the pulmonic valve was not performed.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation visualized. Dedicated through plane imaging of the tricuspid valve was not performed.AortaThe ascending thoracic aorta is normal in size. There is a left sided aortic arch.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 thickening or effusion.
1. Persistent enhancement and epicardial distribution from the mid inferolateral wall extending to the apical lateral wall. A thin rim of enhancement is again noted, not as prominent, at the mid anterolateral wall. The pattern is suggestive of prior myocarditis.2. Left ventricular ejection fraction equal to 55%