70 year old female with pulmonary sarcoidosis with chest pain and palpitations. Evaluation for cardiac involvement. First Pass PerfusionDuring hyperemia, no perfusion defects were present.Viability/ Myocardial ScarThere was no late gadolinium enhancement noted suggesting that there is no prior myocardial infarction, fibrosis, inflammation, or infiltration. The entire myocardium is viable.Left VentricleThe left ventricle is normal in size with low normal systolic function. The overall LV ejection fraction is 53%. The LVEDV is 93 ml (normal range 109+/-23), LV end diastolic volume index is 50 ml/m2 (normal range: 65+/-11), LVESV is 44 ml (normal range 31+/-10), and LV end systolic volume index is 23 ml/m2 (normal range 18+/-5). The LV mass is 103 g (normal range 114+/-24) and the LV mass index is 55 g/m2 (normal range 67+/-11). There is abnormal septal motion consistent with bundle branch block. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. There is no LV thrombus. Left AtriumThe left atrium is normal in size.Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 63%, the RV end diastolic volume index is 56 ml/m2 (normal range 69+/-14), the RVEDV is 106 ml (normal range 110+/-24), the RV end systolic volume index is 21 ml/m2 (normal range 22+/-8), and the RVESV is 39 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve is trileaflet, opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is trace 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 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 no obvious pericardial disease.Extracardiac FindingsThere is extensive mediastinal lymphadenopathy. There are increased lung markings/ infiltrates, as previously noted on CT. 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. No evidence of myocardial ischemia or infarction.2. Normal LV size with low normal systolic function (LVEF 53%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration.3. Normal RV size and systolic function (RVEF 63%). 4. See extracardiac findings.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.