Reason: abnormal stress MRI 6/21/16 with concern for anterior ischemia but alternatively could be her LBBB causing the abnormalitiy. EF 53%. Eval for obstructive CAD. LDL 181. History: chest painCPT Code: 75574 Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. A portion of the mid left main artery is not visualized due to artifact. There are no significant stenoses present in the left main.LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There are no significant stenoses in the LAD.LCx: The left circumflex coronary artery is non-dominant. It courses normally in the left AV groove. It gives rise to the obtuse marginal branches. There is a small non-flow limiting calcified plaque in the proximal circumflex coronary artery.RCA: The right coronary artery is large and arises normally from the right sinus of valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There are no significant stenoses in the right coronary artery.Left Ventricle: The left ventricular late diastolic volume is within normal limits.Right Ventricle: Visually the right ventricular late diastolic volume is within normal limits.Left Atrium: Visually, the left atrial volume appears normal in size. There are four distinct pulmonary veins which drain normally into the left atrium. There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrial volume appears to be normal in size. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. A left sided approach central venous catheter tip is in the right atrium.Valves: There is no calcification on the aortic or mitral valves.Great vessels: The visualized portions of the thoracic aorta demonstrate no evidence of dissection or aneurysm. The aortic arch is not seen. The main pulmonary artery is normal in size.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.CHEST:LUNGS AND PLEURA: Visualization of the lung parenchyma is limited by the field of view and length of scan which excludes a substantial amount of the lungs. No significant abnormality noted. Minimal bibasilar dependent atelectasis.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.
1. Small non-flow limiting calcified plaque in the proximal circumflex coronary artery.2. A segment of the left main coronary artery is not visualized due to artifact. Within this limitation, no significant coronary artery stenoses are present.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report.