63 year old male with history of hypertension, dyslipidemia, and coronary artery disease with myocardial infarction presenting for evaluation of infarct and ejection fraction. Left VentricleThe left ventricle is moderately dilated with mild-moderately reduced systolic function. The overall LV ejection fraction is 43%, the LV end diastolic volume index is 127 ml/m2 (normal range: 74+/-15), the LVEDV is 227 ml (normal range 142+/-34), the LV end systolic volume index is 73 ml/m2 (normal range 25+/-9), the LVESV is 130 ml (normal range 47+/-19). There is hypokinesis in the mid and distal inferolateral and inferior walls and basal infero-septum. There is subendocardial late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process in a pattern typical for myocardial infarction located in the basal-mid inferolateral and inferior and basal infero-septal walls. The infarct is transmural in the basal inferior and mid inferolateral walls and otherwise is < 50% transmurality. Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 98 ml/m2 (normal range 82+/-16), the RVEDV is 177 ml (normal range 142+/-31), the RV end systolic volume index is 49 ml/m2 (normal range 31+/-9), and the RVESV is 89 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 trace 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 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. The left ventricle is moderately dilated with mild-moderately reduced systolic function. The overall LV ejection fraction is 43%. There is hypokinesis in the mid and distal inferolateral and inferior walls and basal infero-septum. There is subendocardial late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process in a pattern typical for myocardial infarction located in the basal-mid inferolateral and inferior and basal infero-septal walls. The infarct is transmural in the basal inferior and mid inferolateral walls and otherwise is < 50% transmurality. 2. The right ventricle is normal in size with normal systolic function (RVEF 50%). 