56 year old female with recent cardiac arrest due to LAD dissection. Patient referred to evaluate cardiac structure and function. Left VentricleThe left ventricle is mildly dilated with low normal systolic function. There is dyskinesis of the apical anterior and septal walls. The overall LV ejection fraction is 54%, the LV end diastolic volume index is 89 ml/m2 (normal range: 65+/-11), the LVEDV is 149 ml (normal range 109+/-23), the LV end systolic volume index is 41 ml/m2 (normal range 18+/-5), the LVESV is 68 ml (normal range 31+/-10), the LV mass index is 31 g/m2 (normal range 67+/-11), and the LV mass is 51 g (normal range 114+/-24). There is transmural late gadolinium enhancement involving the apical anterior and sseptal walls in a pattern consistent with prior myocardial infarction. These segments are not viable. The remainder of the myocardium is free of myocardial infarction and is viable. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 58%, the RV end diastolic volume index is 78 ml/m2 (normal range 69+/-14), the RVEDV is 131 ml (normal range 110+/-24), the RV end systolic volume index is 33 ml/m2 (normal range 22+/-8), and the RVESV is 55 ml (normal range 35+/-13). 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 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. There is a trace pericardial effusion.Extracardiac FindingsThere are trivial pleural effusions. 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. There is a small transmural myocardial infarction involving the apical anterior and septal walls. This territory is not viable. The remainder of the myocardium is free of myocardial infarction and is viable. 2. Mild LV dilation with low normal systolic function (LVEF 54%) with dyskinesis of the apical anterior and septal walls. 3. Normal RV size and systolic function (RVEF 58%). 