48 year-old male with history of ventricular tachycardia and previous ablations. Send for evaluation for scar. Has an ICD Left VentricleThe left ventricle is mildly to moderately dilated with moderately reduced systolic function. The overall LV ejection fraction is 32%, the LV end diastolic volume index is 112 ml/m2 (normal range: 74+/-15), the LVEDV is 227 ml (normal range 142+/-34), the LV end systolic volume index is 76 ml/m2 (normal range 25+/-9), the LVESV is 153 ml (normal range 47+/-19), the LV mass index is 65 g/m2 (normal range 85+/-15), and the LV mass is 132 g (normal range 164+/-36). There is an aneurysm at the basal inferior and infero-lateral walls. There is septal dyssynergy. There is transmural late gadolinium enhancement extending from base to middle segments of the inferior and infero-lateral walls, corresponding to the area of previously described LV aneurysm. This finding is consistent with a prior myocardial infarction. This portion of the myocardium is not viable. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with moderately reduced systolic function. The overall RV ejection fraction is 34%, the RV end diastolic volume index is 88 ml/m2 (normal range 82+/-16), the RVEDV is 179 ml (normal range 142+/-31), the RV end systolic volume index is 58 ml/m2 (normal range 31+/-9), and the RVESV is 117 ml (normal range 54+/-17).Right AtriumThe right atrium is not well seen due to pacemaker artifact.Aortic ValveThe aortic valve is not well seen due to pacemaker artifact.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve is not well seen.Tricuspid ValveThe tricuspid valve is not well seen due to pacemaker artifact.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is not well seen due to pacemaker artifact.Pulmonary VeinsThe right superior pulmonary vein is not well seen. The remaining three 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 FindingsLarge pacemaker artifact covering the right side of the chest. This 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. Large pacemaker artifact covering the right side of the chest. 2. The left ventricle is mildly to moderately dilated with moderately reduced systolic function, the LVEF is 32%.3. A basal inferior/inferolateral aneurysm is noted with thinning of the myocardial wall. 4. There is transmural late gadolinium enhancement extending from base to middle segments of the inferior and infero-lateral walls, corresponding to the area of the described LV aneurysm. This finding is consistent with a prior myocardial infarction. This portion of the myocardium is not viable. 5. The right ventricle is normal in size with moderately reduced systolic function, the RVEF is 34%.