75 year old with aortic stenosis and previous coronary artery disease with history of myocardial infarction presenting for assessment of function and viability Left VentricleThe left ventricle is is mildly enlarged. The overall LV ejection fraction is 30%, the LV end diastolic volume index is 115 ml/m2 (normal range: 74+/-15), the LVEDV is 230 ml (normal range 142+/-34), the LV end systolic volume index is 80 ml/m2 (normal range 25+/-9), the LVESV is 161 ml (normal range 47+/-19). There is an extensive mid-distal anterior, mid-distal septal and apical wall motion abnormality. There is > 50% transmural enhancement in all the hypokinetic segments c/w no-viability. Left AtriumThe left atrium is moderately enlarged. Right VentricleThe right ventricle is normal in size. The overall RV ejection fraction is 40%, the RV end diastolic volume index is 75 ml/m2 (normal range 82+/-16), the RVEDV is 149 ml (normal range 142+/-31), the RV end systolic volume index is 45 ml/m2 (normal range 31+/-9), and the RVESV is 89 ml (normal range 54+/-17).Right AtriumThe right atrium is normal.Aortic ValveThere is significant AS, extensive leaflet calcification prevents determination of leaflet morphology. No AR noted.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 dilated at 33-34mm.Venous AnatomyThe SVC and IVC drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsBL pleural effusions. 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. Moderate to severe LV systolic dysfunction with EF of 30%.There is an extensive mid-distal anterior, mid-distal septal and apical wall motion abnormality. There is > 50% transmural enhancement in all the hypokinetic segments c/w no-viability. 2. Mild RV dysfunction.3. Aortic stenosis