73 year old woman with history of HF with preserved EF (LVEF 49%) and persistent dyspnea with exertion referred for cardiac MRI with vasodilator stress testing. MEDICATIONS: aspirin, atorvastatin, bisoprolol, lasix, Bidil, losartan 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 normal in size with normal systolic function. The overall LV ejection fraction is 59%, the LV end diastolic volume index is 68 ml/m2 (normal range: 65+/-11), the LVEDV is 142 ml (normal range 109+/-23), the LV end systolic volume index is 28 ml/m2 (normal range 18+/-5), the LVESV is 59 ml (normal range 31+/-10), the LV mass index is 51 g/m2, and the LV mass is 108 g. There are no regional wall motion abnormalities present. Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 54%, the RV end diastolic volume index is 72 ml/m2 (normal range 69+/-14), the RVEDV is 152 ml (normal range 110+/-24), the RV end systolic volume index is 33 ml/m2 (normal range 22+/-8), and the RVESV is 70 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve opens widely and there is mild-moderate 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 mild tricuspid regurgitation.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern. There is moderate tortuosity of the descending aorta.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is moderately dilated (35mm).Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsBilateral lower lobe atelectasis. 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. No perfusion defects/ "ischemia" present during hyperemia.2. No prior myocardial infarction. The entire myocardium is viable.3. Normal LV size and systolic function (LVEF 59%) without evidence of replacement fibrosis, inflammation, or infiltration.4. Normal RV size and systolic function (RVEF 54%).5. Mild-moderate aortic regurgitation. 6. Main pulmonary artery dilation. 7. Mild biatrial dilation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.