77 year old female with diabetes, hypertension, hyperlipidemia, and reported history coronary artery disease and angioplasty.MEDICATIONS: Metoprolol, Lisinopril, Aspirin, Metformin, Allopurinol, Glipizide First Pass PerfusionDuring hyperemia, no perfusion defects were present. Viability/ Myocardial ScarThere is high signal at mid-wall noted in the basal inferior wall, which is atypical for prior myocardial infarction. The entire myocardium is viable. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 59%, the LV end diastolic volume index is 89 ml/m2 (normal range: 65+/-11), the LVEDV is 171 ml (normal range 109+/-23), the LV end systolic volume index is 36 ml/m2 (normal range 18+/-5), the LVESV is 69 ml (normal range 31+/-10), the LV mass index is 63 g/m2, and the LV mass is 122 g. There are no regional wall motion abnormalities present. No intracardiac thrombus.Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 61%, the RV end diastolic volume index is 63 ml/m2 (normal range 69+/-14), the RVEDV is 179 ml (normal range 110+/-24), the RV end systolic volume index is 37 ml/m2 (normal range 22+/-8), and the RVESV is 71 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve opens widely and there is aortic regurgitation, visibly trace or mild.Mitral ValveThe mitral valve opens widely. There is mitral regurgitation which appears mild. Dedicated quantification was not performed.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is tricuspid regurgitation which appears mild. Dedicated quantification was not performed.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.Extracardiac FindingsBilateral renal cysts, cholelithiasis.
1. No perfusion defects/ "ischemia" present during hyperemia.2. There is apparent mid-wall high signal at the basal inferior wall, which is atypical for prior myocardial infarction and may be artifactual. The possibility of prior inflammation in this location cannot be excluded. In the absence of wall motion abnormality, active inflammation is not suspected. The entire myocardium is viable. 3. Normal LV size and systolic function (LVEF 59%).4. Normal RV size and systolic function (RVEF 61%).