Mr. Snyder is a 56Yrs male with a past medical history of presyncope, ?ARVC, ventricular tachycardia, ventricular fibrillation and has ICD in place. Left Ventricle: not well seen due to artifact from the ICD and lead. Left AtriumThe left atrium is not well seen due to artifact from the ICD and lead. . Right VentricleImage quality is limited by ICD artifact; however, with following observations are made within the limits of the images available: the right ventricle has systolic crinkling of the free wall and the RVOT appears to have a dyskinetic segment. The RV is moderately dilated with mildly reduced systolic function (RVEF 48%). The overall RV ejection fraction is 48%, the RV end diastolic volume index is 132 ml/m2 (normal range 82+/-16), the RVEDV is 241 ml (normal range 142+/-31), the RV end systolic volume index is 69 ml/m2 (normal range 31+/-9), and the RVESV is 127 ml (normal range 54+/-17).Right AtriumThe right atrium is grossly normal..Extracardiac FindingsLarge artifact from ICD is noted. 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. There is probably RV free wall systolic crinkling and a dyskinetic segment in the RVOT associated with moderate RV dilation. These findings provide 1 major criteria for the diagnosis of arrhythmogenic right ventricular cardiomyopathy; however, given the presence of significant artifact impact image interpretation, the findings should be interpreted with caution. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.