33 year old male with history of CHF, HTN, hypothyroidism, hilar and mediastinal lymphadenopathy. Referred for cardiac MRI to assess for sarcoid. Left VentricleThe left ventricle is severely dilated with global severely reduced systolic function. The overall LV ejection fraction is 18%. The LV myocardium is diffusely thinned out. The LVEDV is 492 ml (normal range 142+/-34), the LV end diastolic volume index is 247 ml/m2 (normal range: 74+/-15), the LVESV is 402 ml (normal range 47+/-19) and the LV end systolic volume index is 202 ml/m2 (normal range 25+/-9). The LV mass is 174 g (normal range 164+/-36) and the LV mass index is 87 g/m2 (normal range 85+/-15). 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 native T1 myocardial relaxation time is 1161 ms in the ventricular septum and 1260 ms in the LV free wall suggestive of the presence of underlying diffuse fibrosis or infiltration.There is no LV thrombus. Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is severely dilated with severely reduced systolic function. The overall RV ejection fraction is 19%. The RVEDV is 438 ml (normal range 142+/-31), RV end diastolic volume index is 220 ml/m2 (normal range 82+/-16), the RVESV is 355 ml (normal range 54+/-17), and the RV end systolic volume index is 178 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is severely dilated.Aortic ValveThe aortic valve is trileaflet, opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild to moderate mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is mild 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 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 FindingsModerate right sided pleural effusion. Hilar and mediastinal adenopathy noted. Focal nodular opacity at the right lung base near the right major fissure. Correlation with recent chest CT is suggested. 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.Severe global left ventricular dilation with severely reduced systolic function (LVEF 18%). No regional wall motion abnormalities.2.Severe right ventricular dilation with severely reduced systolic function (RVEF 19%).3.The native T1 myocardial relaxation time is 1161 ms in the ventricular septum and 1260 ms in the LV free wall suggestive of the presence of underlying diffuse fibrosis or infiltration.4.No late gadolinium enhancement.5.No LV thrombus6.Severe biatrial dilation.7.Moderate right pleural effusion. 8.Hilar and mediastinal adenopathy.