Presentation
No symptoms. Employment-related medical check-up revealed abnormal ECG and dilated left ventricle.
Patient Data
Patient characteristics:
Dimensions: LV 62 mm, RV 39 mm, septum 11 mm
LV function: EF 35%, SV 92 ml, EDV 265 ml (125 ml/m²), ESV 173 ml (82 ml/m²)
RV function: EF 47%, SV 97 ml, EDV 208 ml (98 ml/m²), ESV 111 ml (52 ml/m²)
Mitral valve: normal bifasic flow and E/A ratio, stroke volume 86 ml, peak velocity 0.6 m/sec.
Aortic valve: tricuspid valve, stroke volume 94 ml, peak velocity 1.2 m/sec.
Global hypokinesia of left ventricle, most prominent in several focal areas of thinned ventricular wall and late enhancement. There is extensive late enhancement in a non-ischemic pattern:
- mid-wall of the interventricular septum
- epicardial in the anterior, anterolateral and inferior LV wall
- superior portion of (lateral) papillary muscles.
- inferior RV wall
- RV outflow tract
There is also slight RV hypokinesia without focal akinesia or dyskinesia. No lymphadenopathy or other gross abnormalities visible on survery images.
Conclusion:
Dilated LV with poor function (ejection fraction 35%). Extensive late enhancement in a non-ischemic pattern, most pronounced in LV, but also in RV. Images most consistent with sarcoidosis. Differential diagnosis includes (status after) extensive myocarditis or other cardiomyopathy.
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