63 year old with hypertension and congestive heart failure presenting for evaluation of etiology of heart failure. Left VentricleThe left ventricle is severely dilated with moderately reduced systolic function. The overall LV ejection fraction is 37%, the LV end diastolic volume index is 122 ml/m2 (normal range: 65+/-11), the LVEDV is 263 ml (normal range 109+/-23), the LV end systolic volume index is 77 ml/m2 (normal range 18+/-5), the LVESV is 166 ml (normal range 31+/-10), the LV mass index is 50 g/m2 (normal range 67+/-11), and the LV mass is 109 g (normal range 114+/-24). The LV dysfunction is global. There is mid myocardial late gadolinium enhancement in the septum which can be seen with nonischemic cardiomyopathy to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern is atypical for myocardial infarction. The native T1 times are mildly elevated at 1160 ms. Left AtriumThe left atrium is mild to moderately dilated.Right VentricleThe right ventricle is mildly dilated with mildly reduced systolic function. The overall RV ejection fraction is 47%, the RV end diastolic volume index is 106 ml/m2 (normal range 69+/-14), the RVEDV is 229 ml (normal range 110+/-24), the RV end systolic volume index is 56 ml/m2 (normal range 22+/-8), and the RVESV is 120 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 mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is mild pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is at least mild to 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 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 severely dilated with moderately reduced systolic function. The overall LV ejection fraction is 37%. The LV dysfunction is global. There is mid myocardial late gadolinium enhancement in the septum which can be seen with nonischemic cardiomyopathy to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. This pattern is atypical for myocardial infarction. The native T1 times are mildly elevated at 1160 ms. This can be re-evaluated on MRI follow up in 6-12 months for reassessment.2. The right ventricle is mildly dilated with mildly reduced systolic function. The overall RV ejection fraction is 47%. 