81 year old female with history of paroxysmal atrial fibrillation, carotid atherosclerosis, essential hypertension, coronary artery disease and mitral regurgitation presenting for evaluation of possible cardiac amyloid. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 66%, the LV end diastolic volume index is 53 ml/m2 (normal range: 65+/-11), the LVEDV is 83 ml (normal range 109+/-23), the LV end systolic volume index is 18 ml/m2 (normal range 18+/-5), the LVESV is 28 ml (normal range 31+/-10), the LV mass index is 31 g/m2 (normal range 67+/-11), and the LV mass is 48 g (normal range 114+/-24). 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 severely enlarged.Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 75 ml/m2 (normal range 69+/-14), the RVEDV is 118 ml (normal range 110+/-24), the RV end systolic volume index is 37 ml/m2 (normal range 22+/-8), and the RVESV is 58 ml (normal range 35+/-13). Right AtriumThe right atrium is severely enlarged. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation. There is aortic valve calcification. Mitral ValveThe mitral valve opens widely and there is at least moderate mitral regurgitation. There is mitral valve calcification.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is severe 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 systolic function. The overall LV ejection fraction is 66%2. The right ventricle is normal in size and systolic function. The overall RV ejection fraction is 51%3. Severe biatrial enlargement4. Severe tricuspid regurgitation, at least moderate mitral regurgitation. 5. No evidence of amyloid. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.