56 year old woman with history of VF arrest in the setting of an LAD dissection, referred for serial cardiac MRI to evaluate LV function and scar burden. Left VentricleThe left ventricle is mildly dilated with normal systolic function. The overall LV ejection fraction is 57%, the LV end diastolic volume index is 94 ml/m2 (normal range: 65+/-11), the LVEDV is 166 ml (normal range 109+/-23), the LV end systolic volume index is 42 ml/m2 (normal range 18+/-5), the LVESV is 71 ml (normal range 31+/-10), the LV mass index is 27 g/m2 (normal range 67+/-11), and the LV mass is 46 g (normal range 114+/-24). There is akinesis of the apical septum and anteroapical walls and thinning of the walls. There is persistent late gadolinium enhancement seen in the anteroapical/apical septum which is transmural and consistent with previous myocardial infarction. In addition, there is a new small focus of low signal in the same region suggestive of small calcification.Left AtriumThe left atrium is normal in size.Right VentricleThe right ventricle is upper normal in size with normal systolic function. The overall RV ejection fraction is 62%, the RV end diastolic volume index is 98ml/m2 (normal range 69+/-14), the RVEDV is 167l (normal range 110+/-24), the RV end systolic volume index is 38ml/m2 (normal range 22+/-8), and the RVESV is 64ml (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 trivial 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 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. Evidence of previous myocardial infarction in the apical septum and apical anterior walls with wall thinning, akinesis and transmural late gadolinium enhancement. This looks essentially unchanged when compared to the previous study. 2. The LV is mildly dilated with normal systolic function (EF 57%).3. The RV is upper normal in size with normal systolic function (EF 62%). When compared to the previous study of 2015, the LV function is unchanged and late gadolinium enhancement region is stable.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.