A 78 year old female with personal history of cardiomyopathy with left ventricular thrombus treated with anticoagulants, stroke, peripheral artery disease, hypertension, diabetes mellitus, chronic kidney disease. A recent echocardiography showed mildly reduced systolic function of the left ventricle. Referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with low normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 86 ml/m2 (normal range: 65+/-11), the LVEDV is 155 ml (normal range 109+/-23), the LV end systolic volume index is 40 ml/m2 (normal range 18+/-5), the LVESV is 73 ml (normal range 31+/-10). There is an extensive apical wall motion abnormality with akinesis and extension to the mid septal and anteroseptal wall. Overall, despite akinesis and thinning the majority of the territory is viable. There is transmural enhancement in the apical inferior wall suggesting non-viability. There is < 50% transmural enhancement in the septal / anteroseptum, but this appears viable , the remaining segments have little enhancement.Left AtriumThe left atrium is mildly dilated. The LA volume is 102 ml.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 67%, the RV end diastolic volume index is 57 ml/m2 (normal range 69+/-14), the RVEDV is 103 ml (normal range 110+/-24), the RV end systolic volume index is 19 ml/m2 (normal range 22+/-8), and the RVESV is 34 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve is trileaflet, opens widely and there is mild 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.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 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 normal in size with low normal systolic function, the LVEF is 53%. There are regional wall motion abnormalities present as described above.. 2. Delayed enhancement imaging suggest predominate viability in the areas of wall motion.3. The left atrium is mildly dilated. 4. The right ventricle is normal in size with normal systolic function, the RVEF is 67%. 5. The aortic valve is trileaflet, opens widely and there is mild aortic regurgitation.6. There is mild tricuspid regurgitation.7. No LV apical thrombus noted.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.