67 year old female with coronary artery disease status post LAD stent who presents with atypical chest pain. MEDICATIONS: Aspirin, lisinopril, rosuvastatin, metformin First Pass PerfusionDuring hyperemia, no perfusion defects were present. Viability/ Myocardial ScarThere was no late gadolinium enhancement noted suggesting that there is no prior myocardial infarction, fibrosis, inflammation, or infiltration. The entire myocardium is viable. Left VentricleThe left ventricle is upper limits of normal size and systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 104 ml/m2 (normal range: 74+/-15), the LVEDV is 145 ml (normal range 142+/-34), the LV end systolic volume index is 47 ml/m2 (normal range 25+/-9), the LVESV is 66 ml (normal range 47+/-19), the LV mass index is 54 g/m2, and the LV mass is 75 g. There are no regional wall motion abnormalities present. . Left AtriumThe left atrium is normal sized. Right VentricleThe right ventricle is normal size and systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 73 ml/m2 (normal range 82+/-16), the RVEDV is 101 ml (normal range 142+/-31), the RV end systolic volume index is 36 ml/m2 (normal range 31+/-9), and the RVESV is 50 ml (normal range 54+/-17).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 mild to moderate 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 a trivial pericardial effusionExtracardiac 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. No perfusion defects/ "ischemia" present during hyperemia.2. No prior myocardial infarction. The entire myocardium is viable.3. The LV is upper limits of normal size and has normal systolic function (LVEF 55%).4. Normal RV size and systolic function (RVEF 50%).5. Mild to moderate mitral regurgitation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.