74 year old man with a history of IBS, GERD, OSA on CPAP, DM 2, coronary artery disease s/p PCI most recent ~2014, cardiomyopathy (EF by self report 50%), heart failure, and permanent atrial fibrillation with last cardioversion 15 years ago. MRI evaluation of cardiac function to plan further course of treatment for atrial fibrillation. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 46%. The LVEDV is 143 ml (normal range 142+/-34), the LV end diastolic volume index is 62 ml/m2 (normal range: 74+/-15), the LVESV is 77 ml (normal range 47+/-19) and the LV end systolic volume index is 34 ml/m2 (normal range 25+/-9). There are no regional wall motion abnormalities present. There is a small area of subendocardial late gadolinium enhancement in the mid-basal lateral wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is typical for myocardial infarction. There is no LV thrombus. Left AtriumThe left atrium is severely dilated.RUPV 19x21RLPV 13x16LUPV 17x18LLPV 13x22Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 44%. The RVEDV is 166 ml (normal range 142+/-31), RV end diastolic volume index is 73 ml/m2 (normal range 82+/-16), the RVESV is 94 ml (normal range 54+/-17), and the RV end systolic volume index is 41 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is moderately dilated.Aortic ValveThe aortic valve is trileaflet, opens widely and there is trace 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 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 left ventricular size and mildly reduced systolic function with no significant hypertrophy (LVEF 46%).2.Normal right ventricular size and mildly reduced systolic function with no significant hypertrophy (RVEF 44%).3.Left atrial dilation.4.There is a small area of subendocardial late gadolinium enhancement in the mid-basal lateral wall to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. The pattern is typical for myocardial infarction.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.