Ms. Smith- Gavin is a 46 year-old woman with a history of diabetes, hypertension, sinus tachycardia, goiter, post-surgical hypothyroidism, asthma, obesity, breast cancer s/p lumpectomy chemotherapy with Taxol (last 10/2015) and radiation (completed 1/2016) presenting for evaluation of left ventricular dysfunction. Left VentricleThe left ventricle is normal in size with mildly-moderately reduced systolic function. The overall LV ejection fraction is 44%, the LV end diastolic volume index is 85 ml/m2 (normal range: 65+/-11), the LVEDV is 165 ml (normal range 109+/-23), the LV end systolic volume index is 48 ml/m2 (normal range 18+/-5), the LVESV is 94 ml (normal range 31+/-10), the LV mass index is 54 g/m2 (normal range 67+/-11), and the LV mass is 106 g (normal range 114+/-24). The LV dysfunction is global. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.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 60%, the RV end diastolic volume index is 74 ml/m2 (normal range 69+/-14), the RVEDV is 144 ml (normal range 110+/-24), the RV end systolic volume index is 30 ml/m2 (normal range 22+/-8), and the RVESV is 58 ml (normal range 35+/-13). 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 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.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 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. The left ventricle is normal in size with mildly-moderately reduced systolic function. The overall LV ejection fraction is 44%. The LV dysfunction is global. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The right ventricle is normal in size and systolic function. The overall RV ejection fraction is 60%