71 year old man with history of CAD with known occlusion of the RCA, LV dysfunction, previous stroke, hypertension and peripheral arterial disease referred for cardiac MRI to evaluate cardiac function and assess for scar. Left VentricleThe left ventricle is mildly dilated with moderate-severely reduced systolic function. The overall LV ejection fraction is 35%, the LV end diastolic volume index is 114 ml/m2 (normal range: 74+/-15), the LVEDV is 221 ml (normal range 142+/-34), the LV end systolic volume index is 75 ml/m2 (normal range 25+/-9), the LVESV is 145 ml (normal range 47+/-19), the LV mass index is 82 g/m2 (normal range 85+/-15), and the LV mass is 159 g (normal range 164+/-36). There is an irregularity in the basal anterior wall which resembles an outpouching. In this same area there is hypokinesis of the mid anterior wall. The native T1 relaxation time is elevated at 1100ms, which may represent an element of diffuse fibrosis. There is a very small area of late gadolinium enhancement in the apical inferolateral wall which is transmural, and is suggestive of previous infarction. The remainder of the myocardium is viable.Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 53%, the RV end diastolic volume index is 63 ml/m2 (normal range 82+/-16), the RVEDV is 122 ml (normal range 142+/-31), the RV end systolic volume index is 30 ml/m2 (normal range 31+/-9), and the RVESV is 58 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 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 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. Mildly dilated LV with moderate-severely reduced function (EF 35%). 2. There is an irregularity in the basal anterior wall which resembles an outpouching. In this same area there is hypokinesis of the mid anterior wall.3. There is a very small area of late gadolinium enhancement in the apical inferolateral wall which is transmural, and is suggestive of previous infarction. The remainder of the myocardium is viable.4. Normal size RV with normal systolic function (EF 53%). 5. Mild biatrial dilation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.