Patient is a 41 year old male with history of hypertension, diabetes who presented to an OSH with a NSTEMI. Coronary angiogram showed no significant epicardial coronary artery disease. Cardiac MRI done to evaluate function, structure, and presence of fibrosis. Left VentricleThe left ventricle is moderately enlarged with severely reduced systolic function. The overall LV ejection fraction is 21%, the LV end diastolic volume index is 129 ml/m2 (normal range: 74+/-15), the LVEDV is 238 ml (normal range 142+/-34), the LV end systolic volume index is 102 ml/m2 (normal range 25+/-9), the LVESV is 253 ml (normal range 47+/-19), the LV mass index is 96 g/m2 (normal range 85+/-15), and the LV mass is 238 g (normal range 164+/-36). 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.No intracardiac thrombus.Left AtriumThe left atrium is moderately to severely increased. Right VentricleThe right ventricle is mildly dilated with severely reduced systolic function. The overall RV ejection fraction is 20%, the RV end diastolic volume index is 124 ml/m2 (normal range 82+/-16), the RVEDV is 308 ml (normal range 142+/-31), the RV end systolic volume index is 99 ml/m2 (normal range 31+/-9), and the RVESV is 246 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is trace 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 a small pericardial effusion.Extracardiac FindingsThere are several serpiginous structures at the esophageal hiatus suspicious for small vascular structures. No evidence of cirrhosis, which makes esophageal varices less likely. Correlation to patient's history and liver enzymes recommended.
1. The left ventricle is moderately enlarged with severely reduced systolic function (LVEF 21%)2. The right ventricle is mildly dilated with severely reduced systolic function (RVEF 20%)3. There is no definite late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.