57 year old woman with worsening shortness of breath following pulmonary vein isolation procedure. Referred to rule out pulmonary vein stenosis. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 65%, the LV end diastolic volume index is 55 ml/m2 (normal range: 65+/-11), the LVEDV is 113 ml (normal range 109+/-23), the LV end systolic volume index is 19 ml/m2 (normal range 18+/-5), the LVESV is 74 ml (normal range 31+/-10), the LV mass index is 41 g/m2 (normal range 67+/-11), and the LV mass is 85 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.Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 56%, the RV end diastolic volume index is 47 ml/m2 (normal range 69+/-14), the RVEDV is 97 ml (normal range 110+/-24), the RV end systolic volume index is 21 ml/m2 (normal range 22+/-8), and the RVESV is 43 ml (normal range 35+/-13). AtriaThe left atrium is mildly dilated. The LA volume is 96 ml.The right atrium is mildly dilated. An atrial septal defect closure device is noted.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. There is no evidence of pulmonary vein stenosis.Pulmonary ArteryThe main pulmonary artery is normal in size. Venous AnatomyThe SVC is normal in size and drain normally into the right atrium. The IVC is dilated. Coronary sinus is aneurysmal (16mm) in its mid portion.PericardiumThere is no obvious pericardial disease. Trace 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. Normal LV size and systolic function (LVEF 65%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration.2. Normal RV size and systolic function (RVEF 56%).3. Mild biatrial dilation with evidence of an atrial septal closure device.4. Normal pulmonary vein anatomy without evidence of stenosis.5. Mid portion of coronary sinus is aneurysmal 6. Dilated IVC7. Trivial pericardial effusion.