31 year old male patient with no significant past medical history presenting for evaluation of recent diagnosis of heart failure, etiology unclear. Left VentricleThe left ventricle is severely dilated with severly decreased global function. The overall LV ejection fraction is 16%. The LVEDV is 413 ml (normal range 142+/-34), the LV end diastolic volume index is 167 ml/m2 (normal range: 74+/-15), the LVESV is 347 ml (normal range 47+/-19) and the LV end systolic volume index is 140 ml/m2 (normal range 25+/-9). The LV mass is 312 g (normal range 164+/-36) and the LV mass index is 126 g/m2 (normal range 85+/-15). There are no regional wall motion abnormalities present. Late gadolinium images are limited by increased noise in images, however no late gadolinium enhancement is noted to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.The native T1 myocardial relaxation time is [1037]ms. These values are within normal limits, suggestive of no underlying diffuse fibrosis or infiltration.There is [no]myocardial iron overload. There is [no]LV thrombus. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is dilated with decreased function. The overall RV ejection fraction is 17%. The RVEDV is 315 ml (normal range 142+/-31), RV end diastolic volume index is 127 ml/m2 (normal range 82+/-16), the RVESV is 263 ml (normal range 54+/-17), and the RV end systolic volume index is 106 ml/m2 (normal range 31+/-9).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 mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is moderate 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 presence of a T1 hyperdense lesion measuring 1.6cm in the left lower lobe of the lung, likely representing a calcified granuloma. Further correlation is recommended with CT imaging. Bilateral pleural effusions, right greater than left. 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. Severely dilated left ventricle with severely decreased ejection fraction at 16%2. Dilated right ventricle with severely decreased ejection fraction at 17%3. Mild mitral regurgitation, moderate tricuspid regurgitation.4. No late gadolinium enhancement noted in ventricular myocardium.4. No LV thrombus noted.5. T1 hyperdense lesion measuring 1.6cm in the left lower lobe of the lung, likely representing a calcified granuloma. Further correlation is recommended with CT imaging. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.