57 year old woman with history of LAD dissection and VF arrest with transient associated LV dysfunction, referred for cardiac MRI for determination of scar burden and LV function. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 57%, the LV end diastolic volume index is 92 ml/m2 (normal range: 65+/-11), the LVEDV is 152 ml (normal range 109+/-23), the LV end systolic volume index is 40ml/m2 (normal range 18+/-5), the LVESV is 65ml (normal range 31+/-10), the LV mass index is 43 g/m2 (normal range 67+/-11), and the LV mass is 72 g (normal range 114+/-24). There is thinning of the apical septum. There is persistent dyskinesis of the apical septum and apical anterior segments, similar to the previous study. There is transmural late gadolinium enhancement noted within the dyskinetic segment and consistent with previous infarction. This territory is nonviable. The remaining myocardium appears viable. No LV thrombus is noted. Left AtriumThe left atrium is mildly enlarged. Right VentricleThe right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 58%, the RV end diastolic volume index is 104 ml/m2 (normal range 69+/-14), the RVEDV is 172 ml (normal range 110+/-24), the RV end systolic volume index is 44 ml/m2 (normal range 22+/-8), and the RVESV is 72 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly enlarged. 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.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 are normal in size and drain normally into the right atrium. PericardiumThere is a trivial pericardial effusion.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. Normal size left ventricle with normal systolic function (EF 57%). There is persistent dyskinesis of the anteroapical and apical septum. There is transmural late gadolinium enhancement in these segments and thinning of the walls which suggests previous infarction. No LV thrombus is noted. These findings are unchanged when compared to the previous study. 2. Mildly dilated RV with normal systolic function (EF 58%).3. Mild biatrial dilation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.