27 year old woman with LV dysfunction. She is referred to evaluate etiology. Left VentricleThe left ventricle is severely dilated with moderately reduced systolic function. The overall LV ejection fraction is 37%, the LV end diastolic volume index is 132 ml/m2 (normal range: 65+/-11), the LVEDV is 268 ml (normal range 109+/-23), the LV end systolic volume index is 84 ml/m2 (normal range 18+/-5), the LVESV is 170 ml (normal range 31+/-10), the LV mass index is 88 g/m2 (normal range 67+/-11), and the LV mass is 179 g (normal range 114+/-24). There is global hypokinesis. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. T2-ratio and global relative enhancement are within normal limits. Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 54%, the RV end diastolic volume index is 103 ml/m2 (normal range 69+/-14), the RVEDV is 209 ml (normal range 110+/-24), the RV end systolic volume index is 48 ml/m2 (normal range 22+/-8), and the RVESV is 97 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 and there is moderate to severe 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 mildly dilated.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. Severe left ventricular dilation with moderately reduced systolic function (LVEF 37%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration.2. Mild right ventricular dilation with normal systolic function (RVEF 54%).3. Severe left atrial dilation.4. Moderate to severe mitral regurgitation.5. Mild dilation of main pulmonary artery. 