A 47 year female with a history of cervical cancer s/p LEEP, DLBC lymphoma on chemotherapy EPOCH-R between 2/2015 to 6/2015, a severe RV dilatation with mildly reduced systolic function on echocardiogram and cardiac MRI (4/6/2015). She is referred for cardiac MRI as follow up to evaluate RV function. Left VentricleThe left ventricle is normal in size with very mild LV hypokinesis. The overall LV ejection fraction is 51%, the LV end diastolic volume index is 68 ml/m2 (normal range: 65+/-11), the LVEDV is 138 ml (normal range 109+/-23), the LV end systolic volume index is 34 ml/m2 (normal range 18+/-5), the LVESV is 68 ml (normal range 31+/-10), the LV mass index is 36 g/m2 (normal range 67+/-11), and the LV mass is 72 g (normal range 114+/-24). There is mild global hypokinesis with no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.No iron overload was seen.No intracavitary thrombus was.Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is mildly dilated with mildly to moderately reduced systolic function. The overall RV ejection fraction is 40%, the RV end diastolic volume index is 104 ml/m2 (normal range 69+/-14), the RVEDV is 209 ml (normal range 110+/-24), the RV end systolic volume index is 62 ml/m2 (normal range 22+/-8), and the RVESV is 125 ml (normal range 35+/-13). 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 mild 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 severely dilated (43 mm). Proximal left pulmonary artery is measured at 25 mm and proximal right pulmonary artery is measured at 31 mm. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. A right port catheter was seen in the SVC.PericardiumThere is no pericardial disease.Extracardiac FindingsLeft scapular mass reduced in size with residual thoracic lymphadenopathy. The osseous structures of the left shoulder girdle, including the scapula, are not well visualized. Previous right axillary lymphadenopathy is not visualizedThis 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 very mildly reduced systolic function, qualitatively unchanged compared to previous study. Differences in quantitative measurement are likely due to differences in measurement technique rather than a true difference. 2. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. The right ventricle is mildly dilated with mildly to moderately reduced systolic function, qualitatively unchanged compared to previous study though there is a small quantitative decrease. 4. The left atrium is moderately dilated an the right atrium is mildly dilated. 5. See extra-cardiac findings.