82 year old gentleman with a history of recent anterior ST-elevation myocardial infarction on 12/21/2014, s/p stent. He is now referred for cardiac MRI to further evaluation LV function and infarct burden. Left VentricleThe left ventricle is dilated with severely reduced systolic function. The overall LV ejection fraction is 27%, the LV end diastolic volume index is 136 ml/m2 (normal range: 74+/-15), the LVEDV is 272 ml (normal range 142+/-34), the LV end systolic volume index is 100 ml/m2 (normal range 25+/-9), the LVESV is 199 ml (normal range 47+/-19), the LV mass index is 69 g/m2 (normal range 85+/-15), and the LV mass is 137 g (normal range 164+/-36). There is akinesis with transmural enhancement demonstrated by the apex, apical 2/3 of anterior wall, mid-to-apical septum, apical antero-lateral wall and apical 1/3 inferior wall. The wall thickness of these segments are mildly thinned. The basal-septum and basal antero-lateral wall are hypokinetic. The degree of enhancement is consistent with non viable infarct. There is no intracardiac thrombus.Left AtriumThe left atrium is dilated.Right VentricleThe right ventricle is normal in function. The overall RV ejection fraction is 67%, the RV end diastolic volume index is 58 ml/m2 (normal range 82+/-16), the RVEDV is 116 ml (normal range 142+/-31), the RV end systolic volume index is 19 ml/m2 (normal range 31+/-9), and the RVESV is 38 ml (normal range 54+/-17).Right AtriumThe right atrium is normalAortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild 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 pericardial effusion.Extracardiac FindingsThere is trace right sided pleural effusion. High signal in the right middle lobe raises question of aspiration. Correlation with chest radiograph is recommended. There is fluid in the superior esophagus.
1. The left ventricle is dilated with severely reduced systolic function. The overall LV ejection fraction is 27%. Akinesis of the apex, mid-to-apical anterior wall, mid-to-apical septum, apical antero-lateral wall and apical inferior wall . The basal-septum and basal antero-lateral walls are hypokinetic. Nonviable infarct involving the LAD territory.2. No intracardiac thrombus.3. High signal in the right middle lobe raises question of aspiration. Correlation with chest radiograph is recommended. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.