52 year old male with a history of intermittent AV dissociation due to cardiac sarcoid status-post pacemaker, non-sustained ventricular tachycardia and premature ventricular contraction status-post ablation referred for cardiac MRI. Left VentricleThe left ventricle is normal in size and mildly reduced in systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 82 ml/m2 (normal range: 74+/-15), the LVEDV is 206 ml (normal range 142+/-34), the LV end systolic volume index is 45 ml/m2 (normal range 25+/-9), the LVESV is 114 ml (normal range 47+/-19), the LV mass index is 30 g/m2 (normal range 85+/-15), and the LV mass is 76 g (normal range 164+/-36). There is hypokinesis of the basal septal wall.There is patchy, transmural late gadolinium enhancement in the mid to apical anterior/anterolateral wall that suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal sized. Right VentricleThe right ventricle is normal in size and mildly reduced in systolic function. The overall RV ejection fraction is 45%, the RV end diastolic volume index is 76 ml/m2 (normal range 82+/-16), the RVEDV is 191 ml (normal range 142+/-31), the RV end systolic volume index is 42 ml/m2 (normal range 31+/-9), and the RVESV is 105 ml (normal range 54+/-17). There is a focal area of late gadolinium enhancement in the right ventricle free wall and on the RV-portion of the anteroseptum. Right AtriumThe right atrium is mildly dilated.Aortic ValveThe aortic valve opens widely and there is no 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 mild 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 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. The left ventricle is normal in size and mildly reduced in systolic function (LVEF 45%). There is hypokinesis of the basal septal wall.2. The right ventricle is normal in size and mildly reduced in systolic function (RVEF 45%).3. There is patchy, transmural late gadolinium enhancement in the mid to apical anterior/anterolateral wall. There is a focal area of late gadolinium enhancement in the right ventricle free wall and anteroseptum. These findings are consistent with myocardial damage (either fibrotic or inflammatory) associated with cardiac sarcoidosis.4. The right atrium is mildly dilated.5. There is mild tricuspid regurgitation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.