58 year old man with ischemic cardiomyopathy, referred for follow up evaluation of LV function after medical therapy. Left VentricleThe left ventricle is severely dilated with mildly reduced systolic function. The overall LV ejection fraction is 40%, the LV end diastolic volume index is 150 ml/m2 (normal range: 74+/-15), the LVEDV is 291 ml (normal range 142+/-34), the LV end systolic volume index is 90 ml/m2 (normal range 25+/-9), the LVESV is 175 ml (normal range 47+/-19). There is hypokinesis of the mid anterior/anteroseptal walls. There is akinesis of the apical anterior wall. There is dyskinesis in the apex. There is extensive transmural late gadolinium enhancement in the mid to apical anterior, septal and entire apex. This pattern is typical for myocardial infarction. This is not significantly changed from prior study.Left AtriumThe left atrium is moderate to severely enlarged. Right VentricleThe right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 129 ml/m2 (normal range 82+/-16), the RVEDV is 251 ml (normal range 142+/-31), the RV end systolic volume index is 65 ml/m2 (normal range 31+/-9), and the RVESV is 126 ml (normal range 54+/-17).Right AtriumThe right atrium is moderate to severely dilated.Aortic ValveThe aortic valve opens widely and there is mild aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is at least 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 drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThis 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. The left ventricle is severely dilated with mildly reduced systolic function. The overall LV ejection fraction is 40%.2. There is hypokinesis of the mid anterior/anteroseptal walls. There is akinesis of the apical anterior wall. There is dyskinesis in the apex. There is extensive transmural late gadolinium enhancement in the apex, mid to apical anterior, septal and distal inferior walls. This pattern is typical for myocardial infarction. This is unchanged from the prior study on 9/17/15.3. The right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 50%.4. Overall, there is no significant change from prior study on 9/17/15.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.