An 82 year old male with personal history of coronary artery disease and persistent atrial fibrillation s/p ablation, referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 44%, the LV end diastolic volume index is 76 ml/m2 (normal range: 74+/-15), the LVEDV is 185 ml (normal range 142+/-34), the LV end systolic volume index is 43 ml/m2 (normal range 25+/-9), the LVESV is 104 ml (normal range 47+/-19), the LV mass index is 49 g/m2 (normal range 85+/-15), and the LV mass is 119 g (normal range 164+/-36). There is global hypokinesis. There is late gadolinium enhancement at the basal segment of the inferior and infero-lateral walls in a pattern that spares the endocardium. The pattern is atypical for prior myocardial infarction and suggests the presence of underlying myocardial fibrosis, inflammation, or infiltration. Left AtriumThe left atrium is severely dilated (166ml). Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 48%, the RV end diastolic volume index is 78 ml/m2 (normal range 82+/-16), the RVEDV is 189 ml (normal range 142+/-31), the RV end systolic volume index is 41 ml/m2 (normal range 31+/-9), and the RVESV is 99 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly dilated. 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 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 reduced systolic function, the LVEF is 44%. 2. There is late gadolinium enhancement at the basal segment of the inferior and infero-lateral walls in a pattern that spares the endocardium. The pattern is atypical for prior myocardial infarction and suggests the presence of underlying myocardial fibrosis, inflammation, or infiltration. 3. The left atrium is severely dilated. 4. The right ventricle is normal in size with mildly reduced systolic function, the RVEF is 48%. 5. The right atrium is mildly dilated. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.