72 year old woman with history of coronary artery disease who presents with chest pain and shortness of breath. Patient presents for cardiac MRI to evaluate for myocardial ischemia.MEDICATIONS: carvedilol, furosemide, lisinopril, simvastatin First Pass PerfusionDuring hyperemia, no perfusion defects were present. Viability/ Myocardial ScarThere was no late gadolinium enhancement noted suggesting that there is no prior myocardial infarction, fibrosis, inflammation, or infiltration. The entire myocardium is viable. Left VentricleThe left ventricle is mildly dilated with moderately reduced systolic function. The overall LV ejection fraction is 43 %, the LV end diastolic volume index is 96 ml/m2 (normal range: 65+/-11), the LVEDV is 210 ml (normal range 109+/-23), the LV end systolic volume index is 54 ml/m2 (normal range 18+/-5), the LVESV is 118 ml (normal range 31+/-10), the LV mass index is 63 g/m2, and the LV mass is 139 g. There is global mild hypokinesis.No intracardiac thrombus.Left AtriumThe left atrium is moderately to severely dilated in size. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 42%, the RV end diastolic volume index is 89 ml/m2 (normal range 69+/-14), the RVEDV is 195 ml (normal range 110+/-24), the RV end systolic volume index is 52 ml/m2 (normal range 22+/-8), and the RVESV is 114 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 opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern.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 pericardial effusion.
1. No perfusion defects/ "ischemia" present during hyperemia.2. No prior myocardial infarction. The entire myocardium is viable.3. The left ventricle is mildly dilated with reduced systolic function (LVEF 43%).4. The right ventricle is normal in size with mildly reduced systolic function. (RVEF 42%).5. Left atrial enlargement.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.