A 48 year old female with personal history of hear failure (LVEF of 34%), high degree atrio-ventricular block with a dual-chamber pacemaker, mixed autoimmune disorder, diabetes mellitus. Referred to cardiac MRI for further evaluation. Left VentricleImage quality limits ability to determine LV volumes and LV EF. LV EF is visually moderately reduced. Delayed enhancement images are technically challenging, however 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 VentricleImage quality limits ability to determine RV volumes and RV EF. RV EF is visually mildly reduced.Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely aortic regurgitation could not be evaluated.Mitral ValveThe mitral valve opens widely and there is no obvious mitral regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no obvious 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. There are pacemaker leads in the SVC.PericardiumThere is no pericardial effusion. There is pericardial fat..Extracardiac FindingsThere is a pacemaker in the anterior left chest. 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. Image quality limits ability to determine LV volumes and LV EF. LV EF is visually moderately reduced. 2. Delayed enhancement images are technically challenging, however there is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process3. Image quality limits ability to determine RV volumes and RV EF. RV EF is visually mildly reduced.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.