47 year old female with history of hypertrophic cardiomyopathy presenting with acute pulmonary edema and polymorphic ventricular tachycardia. Left VentricleThe left ventricle is normal in size with low normal systolic function. There is left ventricular hypertrophy with septal predominance (IVS 16 mm, lateral wall 13 mm in four chamber view, in short axis maximum dimension in the basal anterior septum is 15.4 mm) The overall LV ejection fraction is 52%, the LV end diastolic volume index is 88 ml/m2 (normal range: 65+/-11), the LVEDV is 149 ml (normal range 109+/-23), the LV end systolic volume index is 42 ml/m2 (normal range 18+/-5), the LVESV is 71 ml (normal range 31+/-10), the LV mass index is 87 g/m2 (normal range 67+/-11), and the LV mass is 146 g (normal range 114+/-24). 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. There is systolic anterior motion of the mitral valve causing flow acceleration proximal to the aortic valve. There is evidence of LVOT obstruction. Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 45%, the RV end diastolic volume index is 76 ml/m2 (normal range 69+/-14), the RVEDV is 127 ml (normal range 110+/-24), the RV end systolic volume index is 42 ml/m2 (normal range 22+/-8), and the RVESV is 70 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe trileaflet aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is at least moderate regurgitation. The leaflets appear thickened. Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant 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 dilated (MPA 38 mm). Venous AnatomyThe SVC and IVC drain normally into the right atrium. PericardiumThere is a small pericardial effusion. Extracardiac FindingsThere are small bilateral pleural effusions, there is diffuse interstitial markings with fluid in the fissures. There is a liver lesion measuring 34 mm x 34 mm in largest diameter seen. No dedicated imaging of extracardiac findings was performed, suggest dedicated imaging. 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 normal in size with low normal systolic function (LVEF 52%). There is left ventricular hypertrophy. The maximum wall thickness, 16 mm in four chamber mid septum and is 15.4 mm in the basal anterior septum in short axis. There is no evidence of LGE seen. 2. The right ventricle is normal in size with mildly reduced systolic function (RVEF 45%)3. There is systolic anterior motion of the mitral valve with LVOT obstruction. There is at least moderate mitral regurgitation. The constellation of findings is consistent with hypertrophic cardiomyopathy. 4. The main pulmonary is dilated (38 mm). 5. There is biatrial enlargement6. See extra cardiac findings. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.