69 year old woman with history of dilated cardiomyopathy and COPD s/p PEA arrest who presents for cardiac MRI for further evaluation of patient's LV dysfunction Left VentricleThe left ventricle is moderately dilated and severely reduced in systolic function. The overall LV ejection fraction is 28%, the LV end diastolic volume index is 104 ml/m2 (normal range: 65+/-11), the LVEDV is 166 ml (normal range 109+/-23), the LV end systolic volume index is 75 ml/m2 (normal range 18+/-5), the LVESV is 121 ml (normal range 31+/-10), the LV mass index is 49 g/m2 (normal range 67+/-11), and the LV mass is 78 g (normal range 114+/-24). There is global hypokinesis with dyskinetic motion of the ventricular septum. There is a focal apical inferior region of transmural late gadolinium enhancement; this may be indicative of a possible cardioembolic event. In addition, there is septal late gadolinium enhancement that spares the endocardium, suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process and mostly likely represents old myocarditis.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 46%, the RV end diastolic volume index is 57 ml/m2 (normal range 69+/-14), the RVEDV is 91 ml (normal range 110+/-24), the RV end systolic volume index is 30 ml/m2 (normal range 22+/-8), and the RVESV is 49 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 ValveThere is thickening and restricted opening of the MV leaflets with 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 are multiple masses in the liver which are most likely a hemangioma or cyst. 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. The left ventricle is moderately dilated with severely reduced systolic function (28%). There is global hypokinesis with dyskinetic motion of the ventricular septum. 2. There is a focal apical inferior region of transmural late gadolinium enhancement; this may be indicative of a possible cardioembolic event. In addition, there is septal late gadolinium enhancement that spares the endocardium, suggesting the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. The right ventricle is normal in size with mildly reduced systolic function (46%).4. Moderate tricuspid regurgitation. 