78 year old woman with history of hypertension, asthma, mitral regurgitation and recent finding of mild LV dysfunction on echocardiography who was referred for cardiac MRI to evaluate ejection fraction and for any etiologies for LV dysfunction Left VentricleThe left ventricle is severely dilated with well-preserved systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 131 ml/m2 (normal range: 65+/-11), the LVEDV is 243 ml (normal range 109+/-23), the LV end systolic volume index is 59 ml/m2 (normal range 18+/-5), the LVESV is 110 ml (normal range 31+/-10), the LV mass index is 65 g/m2 (normal range 67+/-11), and the LV mass is 122 g (normal range 114+/-24). There is subtle hypokinesis of the basal inferolateral wall. There is associated transmural enhancement at this location compatible with nonviable infarct. Additionally there is limited focus of high signal at the basal inferoseptum, at the RV insertion point. This is a nonspecific finding. No evidence of iron overload in the myocardium.No intracardiac thrombus.Left AtriumThe left atrium is moderately dilated.Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 46%, the RV end diastolic volume index is 93 ml/m2 (normal range 69+/-14), the RVEDV is 173 ml (normal range 110+/-24), the RV end systolic volume index is 50 ml/m2 (normal range 22+/-8), and the RVESV is 94 ml (normal range 35+/-13). No abnormal enhancement.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 with at least mild regurgitation noted. The leaflet tips are thickened.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 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 a trivial pericardial effusion.Extracardiac FindingsIntrathoracic stomach. Left axillary lymph node measuring 17 mm short axis. Correlation to physical examination is recommended. The right axilla is not well visualized. No mediastinal or hilar lymphadenopathy is noted.
1. Severely dilated left ventricle with preserved systolic function (EF 55%). 2. There is transmural enhancement of the basal inferolateral wall with normal wall thickness. This is suggestive of transmural infarct.3. Normal sized right ventricle with mildly reduced systolic function (EF 46%).4. Mitral regurgitation, at least mild. 5. Biatrial dilation.6. Intrathoracic stomach. 7. Enlarged left axillary lymph node; correlation to physical examination is recommended.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.