60 year old woman with history of ischemic cardiomyopathy and 3V CAD, referred for cardiac MRI to evaluate myocardial viability. Left VentricleThe left ventricle is mildly dilated with moderately decreased systolic function. The overall LV ejection fraction is 31%, the LV end diastolic volume index is 110 ml/m2 (normal range: 65+/-11), the LVEDV is 216 ml (normal range 109+/-23), the LV end systolic volume index is 76 ml/m2 (normal range 18+/-5), the LVESV is 149 ml (normal range 31+/-10), the LV mass index is 49 g/m2 (normal range 67+/-11), and the LV mass is 95 g (normal range 114+/-24). There is hypokinesis of the mid anteroseptal, anterior, and anterolateral walls and the apical anterior and septal walls. There is no late gadolinium enhancement of the myocardium. There is extensive viability throughout the myocardium. Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 45%, the RV end diastolic volume index is 81 ml/m2 (normal range 69+/-14), the RVEDV is 160 ml (normal range 110+/-24), the RV end systolic volume index is 45 ml/m2 (normal range 22+/-8), and the RVESV is 88 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve has bi-leaflet tethering with moderate to severe 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.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 in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThere are large bilateral pleural effusions, there is evidence of pulmonary edema,and there is consolidation in the left lower lung which could represent atelectasis or infiltrate. There is a large hiatal hernia. 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. The left ventricle is mildly dilated with moderately decreased systolic function. The overall LV ejection fraction is 31%. There is extensive viability in all 3 coronary artery territories without evidence of any myocardial infarction. 2. The right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 45%.3. Moderate to severe mitral regurgitation.4. See extra-cardiac findings.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.