74 year old male with a history of chronic systolic heart failure, HTN, HLD and gout who presents for cardiac evaluationMEDICATIONS: aspirin, valsartan, carvedilol, tamsulosin. 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 mildly enlarged with mildly reduced systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 113 ml/m2 (normal range: 74+/-15), the LVEDV is 252 ml (normal range 142+/-34), the LV end systolic volume index is 63 ml/m2 (normal range 25+/-9), the LVESV is 140 ml (normal range 47+/-19), the LV mass index is 59 g/m2, and the LV mass is 131 g. The left ventricular dysfunction is global. Native myocardial T1 times are within normal limits. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic. The overall RV ejection fraction is 56%, the RV end diastolic volume index is 93 ml/m2 (normal range 82+/-16), the RVEDV is 207 ml (normal range 142+/-31), the RV end systolic volume index is 41 ml/m2 (normal range 31+/-9), and the RVESV is 91 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.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 trace pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant 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 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. No perfusion defects/ "ischemia" present during hyperemia.2. No prior myocardial infarction. The entire myocardium is viable.3. Normal LV size with mildly reduced systolic function (LVEF 45%) without myocardial fibrosis, inflammation, infiltration.4. Normal RV size and systolic function (RVEF 56%).