85 year old with history of coronary artery disease and ventricular tachycardia presenting for evaluation of scar related VT. Left VentricleThe left ventricle is moderately dilated with moderately reduced. The overall LV ejection fraction is 32%, the LV end diastolic volume index is 122 ml/m2 (normal range: 74+/-15), the LVEDV is 222 ml (normal range 142+/-34), the LV end systolic volume index is 83 ml/m2 (normal range 25+/-9), the LVESV is 151 ml (normal range 47+/-19). There is significant thinning and an associated wall motion abnormality in the mid and basal inferior and inferolateral walls. There is a large area of transmural late gadolinium enhancement in a pattern consistent with myocardial infarction in the mid to basal inferior and inferolateral wall. This area is unlikely to be viable. The remaining myocardium is likely to be viable. Left AtriumThe left atrium is mildly enlarged. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 65 ml/m2 (normal range 82+/-16), the RVEDV is 118 ml (normal range 142+/-31), the RV end systolic volume index is 31 ml/m2 (normal range 31+/-9), and the RVESV is 57 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 mild 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 FindingsThere are diffuse bilateral infiltrates in lung field and bilateral small pleural effusions. Atherosclerosis in descending thoracic aorta. 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. The left ventricle is moderately dilated with moderately reduced systolic function. The overall LV ejection fraction is 32%. There is significant thinning and an associated wall motion abnormality in the mid and basal inferior and inferolateral walls. There is a large area of transmural late gadolinium enhancement in a pattern consistent with myocardial infarction in the mid to basal inferior and inferolateral wall. This area is unlikely to be viable. The remaining myocardium is likely to be viable. 2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 52%3. Extracardiac findings as above. 