48 year old female with vulvar cancer, chest pain, troponinemia without epicardial coronary artery disease on coronary angiogram, pericardial effusion referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal size and systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 80 ml/m2 (normal range: 65+/-11), the LVEDV is 150 ml (normal range 109+/-23), the LV end systolic volume index is 36 ml/m2 (normal range 18+/-5), the LVESV is 68 ml (normal range 31+/-10), the LV mass index is 64 g/m2 (normal range 67+/-11), and the LV mass is 121 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. The pre-contrast native myocardial T1 relaxation times are elevated (1160 ms). There is mild diffuse high T2 signal involving the myocardium suggesting edema.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 56%, the RV end diastolic volume index is 76 ml/m2 (normal range 69+/-14), the RVEDV is 145 ml (normal range 110+/-24), the RV end systolic volume index is 34 ml/m2 (normal range 22+/-8), and the RVESV is 64 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. 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 not completely assessed. Grossly no significant 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 normal in size. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is a small pericardial effusion. There is mild enhancement of the pericardium with late gadolinium enhancement imaging and high signal on T2-STIR imaging. There is no evidence of pericardial constriction noted. Extracardiac FindingsThere is a moderate sized left pleural effusion and small sized right pleural effusion. There is mild compressive atelectasis of the left lung. 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. Findings as above correlating with acute pericarditis with trace pericardial effusion but evidence of constrictive physiology.2. The pre-contrast native myocardial T1 relaxation times are elevated (1160 ms) and there is mild high T2 signal likely representing mild myocardial edema. 3. The left ventricle is normal size and systolic function (LVEF 55%).4. The right ventricle is normal size and systolic function (RVEF 56%).5. There is a moderate sized left pleural effusion and small sized right pleural effusion.