53-year-old man with history of ischemic cardiomyopathy. Evaluate for viability. Left VentricleThere is moderate left ventricular enlargement with global moderate reduction in left ventricular ejection fraction with regional variation. Akinesis versus dyskinesis of the left ventricular apex. Relative thinning of the mid anterior, lateral, and inferior walls of the left ventricle as well as the apex of the left ventricle. There is late gadolinium enhancement within the LV myocardium: 1.Essentially transmural at the LV apex2. Up to 50% of the subendocardial LV wall thickness in the apical septal, inferior, and lateral walls3. Clearly less than 50% of the subendocardial LV wall thickness in the mid lateral wall.Small thrombus is noted at the apex of the left ventricle.Left AtriumThe left atrium is normal in size.. Right VentricleThe right ventricle is normal in size and functionRight 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.Extracardiac FindingsNo significant extracardiac findings. 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 late gadolinium enhancement within the LV myocardium consistent with previous myocardial infarct: a. Essentially transmural at the LV apexb. Up to 50% of the subendocardial LV wall thickness in the apical septal, inferior, and .lateral wallsc. Clearly less than 50% of the subendocardial LV wall thickness in the mid lateral wall.2. Moderate left ventricular enlargement with global moderate reduction in left ventricular ejection fraction with regional variation. Akinesis versus dyskinesis of the left ventricular apex. 3. Relative thinning of the mid anterior, lateral, and inferior walls of the left ventricle as well as the apex of the left ventricle. 4. Small thrombus noted at the LV apex, as noted on recent echocardiogram.An addendum will be made to this report once quantitative measurements of the right ventricle and left ventricle are available.