51 year old woman with coronary artery disease s/p CABG referred to evaluate for ischemia. First Pass PerfusionDuring hyperemia, a perfusion defect is noted in the basal anteroseptum and mid anterolateral and anteroseptum. Viability/ Myocardial ScarThere is a nontransmural myocardial infarction noted in the apical septum and the mid anterior and anteroseptal. These segments have an intermediate probability of viability. The remainder of the myocardium is free of myocardial infarction and likely to be viable. Left VentricleThe left ventricle is normal in size and systolic function. The left ventricle is mildly hypertrophied.. The overall LV ejection fraction is 61%, the LV end diastolic volume index is 72 ml/m2 (normal range: 65+/-11), the LVEDV is 164 ml (normal range 109+/-23), the LV end systolic volume index is 28 ml/m2 (normal range 18+/-5), the LVESV is 64 ml (normal range 31+/-10), the LV mass index is 85 g/m2, and the LV mass is 192 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 76%, the RV end diastolic volume index is 57 ml/m2 (normal range 69+/-14), the RVEDV is 131 ml (normal range 110+/-24), the RV end systolic volume index is 14 ml/m2 (normal range 22+/-8), and the RVESV is 99 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.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 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. During hyperemia, a perfusion defect is noted in the basal anteroseptum and mid anterolateral and anteroseptum. 2. There is a nontransmural myocardial infarction noted in the apical septum and the mid anterior and anteroseptal walls. These segments have an intermediate probability of viability. The remainder of the myocardium is free of myocardial infarction and likely to be viable. 3. Normal LV size and systolic function (LVEF 61%).4. Normal RV size and systolic function (RVEF 76%).