40 year old woman with history of post-operatively noted PVC with burden of 16% by Holter monitor, referred to evaluate for underlying cardiomyopathies including ARVC. Left VentricleThe left ventricle is moderately dilated with low-normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 106 ml/m2 (normal range: 65+/-11), the LVEDV is 183 ml (normal range 109+/-23), the LV end systolic volume index is 50 ml/m2 (normal range 18+/-5), the LVESV is 86 ml (normal range 31+/-10), the LV mass index is 38 g/m2 (normal range 67+/-11), and the LV mass is 66 g (normal range 114+/-24). Wall motion is normal. Wall thickness is normal (mid septum ~8mm thickness). There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.The native T1 myocardial relaxation time is 1100-1150ms in the basal to mid septum, which is elevated. These values are mildly elevated, suggestive of underlying diffuse fibrosis or infiltration. There is no obvious evidence for non-compacted LV morphology. There is no LV thrombus. Left AtriumThe left atrium is mildly dilated.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 83 ml/m2 (normal range 69+/-14), the RVEDV is 142 ml (normal range 110+/-24), the RV end systolic volume index is 40 ml/m2 (normal range 22+/-8), and the RVESV is 68 ml (normal range 35+/-13). There are no regional wall motion abnormalities.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 no significant 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 a trivial 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. Moderately dilated left ventricle with low normal systolic function (EF 53%). There is no late gadolinium enhancement to suggest a focal infiltrative, inflammatory or fibrotic process. However, the native T1 myocardial relaxation time is mildly elevated, which could suggest a diffuse underlying fibrotic process. 2. Normal size right ventricle with normal systolic function (EF 52%) and no regional wall motion abnormalities. 3. Mild left atrial dilation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.