60 year old with history of left ventricular dysfunction, hypertension, obesity and pulmonary sarcoidosis presenting for pre-operative stress and evaluation of LV function. MEDICATIONS: aspirin, nifedipine First Pass PerfusionDuring hyperemia, no perfusion defects were present. Viability/ Myocardial ScarThere was no late gadolinium enhancement noted suggesting that there is no prior myocardial infarction, fibrosis, inflammation, or infiltration. The entire myocardium is viable. Left VentricleThe left ventricle is moderately enlarged quantitively (severely when indexed to BSA)with mildly reduced systolic function. The overall LV ejection fraction is 43%, the LV end diastolic volume index is 110 ml/m2 (normal range: 65+/-11), the LVEDV is 211 ml (normal range 109+/-23), the LV end systolic volume index is 63 ml/m2 (normal range 18+/-5), the LVESV is 120 ml (normal range 31+/-10), the LV mass index is 47 g/m2, and the LV mass is 90 g. The LV dysfunction is global. Left AtriumThe left atrium is mild to moderately dilated. Right VentricleThe right ventricle is mildly enlarged with mildly reduced systolic function. The overall RV ejection fraction is 46%, the RV end diastolic volume index is 100 ml/m2 (normal range 69+/-14), the RVEDV is 191 ml (normal range 110+/-24), the RV end systolic volume index is 54 ml/m2 (normal range 22+/-8), and the RVESV is 103 ml (normal range 35+/-13). Right AtriumThe right atrium is Mildly dilated. 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 no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern.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 FindingsMultiple right renal cysts. 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. No perfusion defects/ "ischemia" present during hyperemia. 2. No prior myocardial infarction. The entire myocardium is viable.3. Moderately dilated LV with mildly reduced systolic function (LVEF 43%).4. Mildly enlarged RV size with mildly reduced systolic function (RVEF 46%).