56 year old male with a history of hypertension, obesity, left ventricular hypertrophy with concern for hypertrophic cardiomyopathy on echocardiography. He is referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 70%, the LV end diastolic volume index is 82 ml/m2 (normal range: 74+/-15), the LVEDV is 213 ml (normal range 142+/-34), the LV end systolic volume index is 25 ml/m2 (normal range 25+/-9), the LVESV is 65 ml (normal range 47+/-19), the LV mass index is 86 g/m2 (normal range 85+/-15), and the LV mass is 223 g (normal range 164+/-36). There is severe, asymmetric left ventricular hypertrophy. The mid-wall septum ranges from 21-24 mm and the lateral wall is 12-14 mm. There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 73%, the RV end diastolic volume index is 76 ml/m2 (normal range 82+/-16), the RVEDV is 197 ml (normal range 142+/-31), the RV end systolic volume index is 21 ml/m2 (normal range 31+/-9), and the RVESV is 54 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately 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. There is no systolic anterior motion of the anterior mitral leaflet and there is no evidence of LVOT gradient. Pulmonic ValveThe pulmonic valve is not well-visualized.Tricuspid ValveThe tricuspid valve is not well-visualized.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 not well seen.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 and systolic function (LVEF 70%).2. The right ventricle is normal in size and systolic function. (RVEF 73%).3. There is severe, asymmetric left ventricular hypertrophy. The mid-wall septum ranges from 21-24 mm and the lateral wall is 12-14 mm. There is no outflow tract obstruction or systolic anterior motion of the mitral valve noted. 4. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. 5. There is biatrial enlargement. 6. Overall the findings could be consistent with hypertrophic cardiomyopathy without obstruction. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.