68 year old man with history of PVCs, referred for evaluation of LV dysfunction or underlying fibrosis. Left VentricleThe left ventricle is mildly dilated with low normal systolic function. There is mild concentric left ventricular hypertrophy. The overall LV ejection fraction is 51%, the LV end diastolic volume index is 110 ml/m2 (normal range: 74+/-15), the LVEDV is 209 ml (normal range 142+/-34), the LV end systolic volume index is 53 ml/m2 (normal range 25+/-9), the LVESV is 102 ml (normal range 47+/-19), the LV mass index is 90 g/m2 (normal range 85+/-15), and the LV mass is 171 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is a small "patch" of late gadolinium enhancement in the basal inferoseptum. It is patchy and in a pattern atypical for myocardial infarction and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is mild to moderately dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 56%, the RV end diastolic volume index is 88 ml/m2 (normal range 82+/-16), the RVEDV is 168 ml (normal range 142+/-31), the RV end systolic volume index is 39 ml/m2 (normal range 31+/-9), and the RVESV is 73 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild to moderate 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 "psuedo-bovine" brachiocephalic branching pattern (normal variant). The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is mildly dilated.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease. A trivial pericardial effusion is noted. Extracardiac FindingsThe thyroid is enlarged. 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. The left ventricle is mildly dilated and mildly hypertrophied with low normal systolic function. The overall LV ejection fraction is 51%. There is a small "patch" of late gadolinium enhancement in the basal inferoseptum. It is patchy and in a pattern atypical for myocardial infarction and suggests the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 56%.3. Mild dilation of the main pulmonary artery.4. Mild to moderate mitral regurgitation.5. Mild to moderate left atrial dilation. 6. See extra-cardiac findings. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.