56 year old male with history of CAD s/p LAD stent, htn, hpl now with chest pain for who presents for stress cardiac MRI to evaluate for ischemiaMEDICATIONS: lipitor, xarelto, bystolic, lisinopril, methotrexate, colchicine First Pass PerfusionDuring hyperemia, there is possible mild perfusion defect present in the apical inferior wall.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 normal in size with normal systolic function. The overall LV ejection fraction is 66%, the LV end diastolic volume index is 63 ml/m2 (normal range: 65+/-11), the LVEDV is 131 ml (normal range 109+/-23), the LV end systolic volume index is 21 ml/m2 (normal range 18+/-5), the LVESV is 44 ml (normal range 31+/-10), the LV mass index is 66 g/m2, and the LV mass is 132 g. There are no regional wall motion abnormalities present. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 54%, the RV end diastolic volume index is 84 ml/m2 (normal range 69+/-14), the RVEDV is 176 ml (normal range 110+/-24), the RV end systolic volume index is 39 ml/m2 (normal range 22+/-8), and the RVESV is 81 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 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.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 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. There is a mild perfusion defect noted in the apical inferior wall which appears unchanged from the study performed in 9/6/20112. No prior myocardial infarction. The entire myocardium is viable.3. Normal LV size and systolic function (LVEF 66%).4. Normal RV size and systolic function (RVEF 54%).