66 year old woman with AML, LV dysfunction and NSVT, referred for stress CMR for further evaluation of underlying etiology of cardiomyopathy. MEDICATIONS: amiodarone, coreg, lasix, losartan, crestor, aldactone First Pass PerfusionDuring hyperemia, there is a possible small perfusion defect in the mid inferolateral wall with a corresponding perfusion defect score of 6% (2/32).Viability/ Myocardial ScarThere is a small line of mid myocardial late gadolinium enhancement in the basal septum ("mid wall stripe"). This pattern is often seen in non-ischemic dilated cardiomyopathies. The presence could also suggest an underlying fibrosing, infiltrative, or inflammatory process. In addition, there is a second small area of late gadolinium enhancement in the mid inferolateral wall, the significance of which is uncertain. The remaining myocardium is viable. Left VentricleThe left ventricle is severely dilated with moderately reduced systolic function. The overall LV ejection fraction is 37%, the LV end diastolic volume index is 136 ml/m2 (normal range: 65+/-11), the LVEDV is 243 ml (normal range 109+/-23), the LV end systolic volume index is 86 ml/m2 (normal range 18+/-5), the LVESV is 154 ml (normal range 31+/-10), the LV mass index is 60 g/m2, and the LV mass is 108 g. LV dysfunction is global with regional variation.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 62%, the RV end diastolic volume index is 84 ml/m2 (normal range 69+/-14), the RVEDV is 151 ml (normal range 110+/-24), the RV end systolic volume index is 32 ml/m2 (normal range 22+/-8), and the RVESV is 58 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. The leaflet tips appear thickened. There is at least moderate 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 "psuedo-bovine" brachiocephalic branching pattern (normal variant).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 small perfusion defect in the mid inferolateral wall with a corresponding perfusion defect score of 6% (2/32).2. There is a small line of mid myocardial late gadolinium enhancement in the basal septum ("mid wall stripe"). This pattern is often seen in non-ischemic dilated cardiomyopathies. The presence could also suggest an underlying fibrosing, infiltrative, or inflammatory process. In addition, there is a second small area of late gadolinium enhancement in the mid inferolateral wall, the significance of which is uncertain. The remaining myocardium is viable3. The left ventricle is severely dilated with moderately reduced systolic function. The overall LV ejection fraction is 37%.4. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 62%.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.