55 year old male with history of DVT /PE, HTN, DM, hemachromatosis (heterozygous), and family history of premature CAD who presents for evaluation of possible cardiac involvement of sarcoidosis given history of palpitations/PVCs. Left VentricleThe left ventricle is normal in size with low normal systolic function (LVEF 54%). The overall LV ejection fraction is 54%, the LV end diastolic volume index is 52 ml/m2 (normal range: 74+/-15), the LVEDV is 132 ml (normal range 142+/-34), the LV end systolic volume index is 23 ml/m2 (normal range 25+/-9), the LVESV is 60 ml (normal range 47+/-19), the LV mass index is 45 g/m2 (normal range 85+/-15), and the LV mass is 116 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is late gadolinium enhancement in the basal inferolateral wall and possibly a small patch in the apical inferolateral wall, both of which were previously present. Native myocardial T1 and T2 times are within normal limits, suggesting no active myocardial inflammation. No intracardiac thrombus.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 55%, the RV end diastolic volume index is 62 ml/m2 (normal range 82+/-16), the RVEDV is 159 ml (normal range 142+/-31), the RV end systolic volume index is 34 ml/m2 (normal range 31+/-9), and the RVESV is 88 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is mild 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 at least mild tricuspid regurgitation. AortaThere is a left sided aortic arch with a common origin of the innominate and left common carotid artery. The aortic root is mildly dilated (SoV 45 mm).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 drain normally into the right atrium.PericardiumThere is no pericardial effusion.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 with low normal systolic function (LVEF 54%). There is a small patch of late gadolinium enhancement in the basal inferolateral wall and apical inferolateral wall suggesting of an underlying fibrotic process consistent with prior episode of cardiac sarcoid. Based on normal myocardial T1 and T2 times, there is no evidence of active myocardial inflammation. 2. The right ventricle is normal in size and systolic function (RVEF 58%)3. Mild dilatation of the Sinus of Valsalva. 4. When compared to cardiac MRI from 9/14/2015, no significant change. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.