27 year old male with Beckwith-Widemann, HIV, syphillis and aortic stenosis s/p repair presenting for evaluation of aortic regurgitation and left ventricular size and function. Left VentricleThe left ventricle is moderately dilated with normal systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 129 ml/m2 (normal range: 74+/-15), the LVEDV is 260 ml (normal range 142+/-34), the LV end systolic volume index is 58 ml/m2 (normal range 25+/-9), the LVESV is 118 ml (normal range 47+/-19), the LV mass index is 77 g/m2 (normal range 85+/-15), and the LV mass is 155 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.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with low normal systolic function. The overall RV ejection fraction is 48%, the RV end diastolic volume index is 107 ml/m2 (normal range 82+/-16), the RVEDV is 215 ml (normal range 142+/-31), the RV end systolic volume index is 55 ml/m2 (normal range 31+/-9), and the RVESV is 110 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly enlarged in size.Aortic ValveThe aortic valve opens widely and there moderate aortic regurgitation, regurgitation fraction was calculated at 25%.Mitral ValveThe mitral valve opens widely and there is at least mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is at least trivial tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is borderline in size. The sinus of Valsalva is 37 mm, sinotubular junction is 29 mm, ascending aorta (at 5 cm above aortic annulus), and aortic arch 27 mm.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is mildly dilated (31mm x 30mm).Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsEvidence of a sternotomy. 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 moderately dilated with normal systolic function. The overall LV ejection fraction is 55%. 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.2. The right ventricle is normal in size with low normal systolic function. The overall RV ejection fraction is 48%. 3. Aortic measurements as above, with moderate aortic regurgitation. 