61 year old male with a history of ischemic cardiomyopathy s/p NSTEMI with percutaneous coronary intervention to the LAD in 12/2015 with residual LCx disease. Patient referred for cardiac MRI for further evaluation. Left VentricleThe left ventricle is mildly dilated with low-normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 117 ml/m2 (normal range: 74+/-15), the LVEDV is 225 ml (normal range 142+/-34), the LV end systolic volume index is 55 ml/m2 (normal range 25+/-9), the LVESV is 105 ml (normal range 47+/-19), the LV mass index is 45 g/m2 (normal range 85+/-15), and the LV mass is 87 g (normal range 164+/-36). There is thinning of the apical to basal lateral to inferolateral wall with associated hypokinesis/akinesis. There is late gadolinium enhancement of the apical to basal inferior, anterolateral, and inferolateral wall that is nearly full thickness (75%) to full thickness (lower probability of viability), corresponding to the LCx territory. Additionally, there is partial-thickness subendocardial late gadolinium enhancement (~50%) of the apical to mid anterior wall (intermediate viability). Pre-contrast native myocardial T1 relaxation times is normal (1010 ms) at the level of the septum. Left AtriumThe left atrium is normal sized. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 53%, the RV end diastolic volume index is 102 ml/m2 (normal range 82+/-16), the RVEDV is 196 ml (normal range 142+/-31), the RV end systolic volume index is 48 ml/m2 (normal range 31+/-9), and the RVESV is 92 ml (normal range 54+/-17).Right AtriumThe right atrium is normal sized.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 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 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. The left ventricle is mildly dilated with low-normal systolic function (LVEF 53%).2. The right ventricle is normal in size and systolic function (RVEF 53%). 3. There is thinning of the apical lateral and mid and basal anterolateral and inferolateral walls with associated hypokinesis/akinesis.4. There is partial-thickness subendocardial late gadolinium enhancement (~50%) of the apical to mid anterior wall (intermediate viability). Additionally. there is late gadolinium enhancement of the apical to mid inferior, anterolateral, and inferolateral wall that is nearly full thickness to full thickness correlating with nonviable myocardium and corresponding to the LCx territory. 