20 year old female with syncope referred for further evaluation. Left VentricleThe left ventricle is severely dilated with low normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 118 ml/m2 (normal range: 65+/-11), the LVEDV is 208 ml (normal range 109+/-23), the LV end systolic volume index is 56 ml/m2 (normal range 18+/-5), the LVESV is 98 ml (normal range 31+/-10), the LV mass index is 76 g/m2 (normal range 67+/-11), and the LV mass is 134 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 normal in size. The LA volume is 76 ml.Right VentricleThe right ventricle is moderately dilated with mildly reduced systolic function. The overall RV ejection fraction is 45%, the RV end diastolic volume index is 115 ml/m2 (normal range 69+/-14), the RVEDV is 203 ml (normal range 110+/-24), the RV end systolic volume index is 62 ml/m2 (normal range 22+/-8), and the RVESV is 110 ml (normal range 35+/-13). No focal or regional wall motion abnormalities noted. Right AtriumThe right atrium is mildly dilated (105ml). Aortic ValveThe aortic valve opens widely and is trileaflet. There is mild 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 no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root and thoracic aorta are normal in size. No evidence of aortic coarctation. Normal origin of the right and left coronary artery arteries. Sinus of Valsalva: 34x32x31mmST Junction: 29mmAscending Aorta: 30x31mmPulmonary 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 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 LV dilation with low normal systolic function (LVEF 53%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration.2. Moderate RV dilation with mildly reduced systolic function (RVEF 45%) without evidence of focal or regional aneurysm. 3. Normal left atrial volume.4. Mild right atrial dilation.5. Tricuspid aortic valve with mild aortic regurgitation.6. Normal thoracic aorta.7. Normal origins of the coronary arteries. 8. Small pericardial effusion.