61 year old female with history of ischemic cardiomyopathy, hypertension, COPD, diabetes, chronic kidney disease, peripheral arterial disease, Hodgkin's lymphoma s/p chemotherapy here for evaluation for advanced options. Left VentricleThe left ventricle is normal in size with mild to moderately reduced systolic function. There is a basal septal hypertrophy. The overall LV ejection fraction is 42% The left ventricular systolic function is global with regional variation. Specifically, the apical inferior, lateral and anterior wall, mid inferolateral and anteroseptal walls, the LV end diastolic volume index is 87 ml/m2 (normal range: 65+/-11), the LVEDV is 168 ml (normal range 109+/-23), the LV end systolic volume index is 51 ml/m2 (normal range 18+/-5), the LVESV is 98 ml (normal range 31+/-10), the LV mass index is 52 g/m2 (normal range 67+/-11), and the LV mass is 100 g (normal range 114+/-24). There is late gadolinium enhancement (LGE) in the pattern of coronary artery disease with multiple infarctions. In the apex, there is a full thickness transmural infarct. In the junction of the basal 1/3 and mid 1/3 of the there is a punctate area of LGE that is less than 50% in thickness. The anterior apical wall has a 60% subendocardial infarct present and the infero-lateral and inferior walls have a greater than 50% thickness infarct from the mid to apical portions. These areas of LGE are likely not viable. and there is no left ventricular thrombus present. Left AtriumThe left atrium is mild-moderately enlarged. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 60 ml/m2 (normal range 69+/-14), the RVEDV is 116 ml (normal range 110+/-24), the RV end systolic volume index is 51 ml/m2 (normal range 22+/-8), and the RVESV is 98 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 at least trace mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is tricuspid regurgitation.AortaThere is a left sided aortic arch with a common origin of the innominate and left common carotid artery. The aorta is normal in size. There atherosclerosis in the descending aorta. 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 pericardial effusion.Extracardiac FindingsThere is a T2 hyperintense lesion in the liver that may represent a cyst; however, this is not completely characterized. There is T2 hyperintensity in several mid thoracic vertebrae which may represent hemangiomas which not completely characterized on the current exam. Sternotomy wires are present consistent with coronary artery bypass surgery.
1. The left ventricle is normal in size with mild-moderately reduced systolic function (LVEF 42%)2. The right ventricle is normal in size and systolic function (RVEF 52%)3. The left ventricular systolic function is global with regional variation as described above, there are significant areas of late gadolinium enhancement which are likely not viable (described above). 