65 year old woman with history of hypertension presents for a stress cardiac MRI to evaluate for ischemic etiology of chest pain.MEDICATIONS: Toprol XL 25mg, Multi-vitamin, COQ10 First Pass PerfusionDetection of perfusion defect during hyperemia was non-diagnostic due to technical limitations related to poor breath-holds and likely displacement of the surface coil.Viability/ Myocardial ScarThere is probably 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 normal in size with hyperdynamic systolic function. The overall LV ejection fraction is 77%, the LV end diastolic volume index is 46 ml/m2 (normal range: 65+/-11), the LVEDV is 74 ml (normal range 109+/-23), the LV end systolic volume index is 10 ml/m2 (normal range 18+/-5), the LVESV is 17 ml (normal range 31+/-10), the LV mass index is 34 g/m2, and the LV mass is 55 g. There are no regional wall motion abnormalities present. 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 75 %, the RV end diastolic volume index is 47 ml/m2 (normal range 69+/-14), the RVEDV is 77 ml (normal range 110+/-24), the RV end systolic volume index is 12 ml/m2 (normal range 22+/-8), and the RVESV is 19 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. Mild atherosclerosis is noted in the descending thoracic aorta.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 trivial pericardial effusion.Extracardiac FindingsThyroid enlargement is noted 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. Detection of perfusion defect during hyperemia was non-diagnostic due to technical limitations 2. No obvious prior myocardial infarction. The entire myocardium is viable.3. Normal LV size and systolic function (LVEF 77%) without obvious evidence of myocardial fibrosis, infiltration, or inflammation.4. Normal RV size and systolic function (RVEF 78%).5. See extra-cardiac findings.6. Study is technically limited due to poor image quality.