62 year od man referred for evaluation of infiltrative disease. Left VentricleThe left ventricle is severely hypertrophied and dilated with severely reduced systolic function. The IVSd=17mm. The overall LV ejection fraction is 29%, the LV end diastolic volume index is 182 ml/m2 (normal range: 74+/-15), the LVEDV is 393 ml (normal range 142+/-34), the LV end systolic volume index is 129 ml/m2 (normal range 25+/-9), the LVESV is 278 ml (normal range 47+/-19), the LV mass index is 155 g/m2 (normal range 85+/-15), and the LV mass is 335 g (normal range 164+/-36). There is global hypokinesis which is most pronounced along the basal to mid inferior wall. The native myocardial T1 relaxation time is moderate to severely elevated along the basal anterior, mid anterior and anteroseptal, and apical anterior, septal, and lateral walls. No evidence of myocardial iron overload. Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is severely dilated with severely reduced systolic function. The overall RV ejection fraction is 29%, the RV end diastolic volume index is 197 ml/m2 (normal range 82+/-16), the RVEDV is 426 ml (normal range 142+/-31), the RV end systolic volume index is 140 ml/m2 (normal range 31+/-9), and the RVESV is 302 ml (normal range 54+/-17).Right AtriumThe right atrium is severely dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild to moderate mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild to 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 moderately dilated.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. A catheter is noted in the SVC.PericardiumThere is a small pericardial effusion.Extracardiac FindingsThere is significant thyromegaly. 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. Severe LVH with severe LV dilation and severely reduced systolic function (LVEF 29%). 2. The native myocardial T1 relaxation time is moderate to severely elevated, which supports the presence of significant myocardial fibrosis or infiltration. 3. Severe RV dilation with severely reduced systolic function (RVEF 29%).4. Severe biatrial dilation.5. Mild to moderate mitral and tricuspid regurgitation.6. Moderate dilation of main pulmonary artery.7. Small pericardial effusion.8. Significant thyroid enlargement. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.