77 year old man with multivessel coronary artery disease referred to assess for myocardial viability. Left VentricleThe left ventricle is severely dilated with severely reduced systolic function (estimated LVEF 25%). There is no obvious late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. There is extensive myocardial viability in all three coronary artery territories.Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is mildly dilated with normal systolic function. Right AtriumThe right atrium is mildly dilated.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size. There is mild protruding atheroma in the descending thoracic aorta. Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is mildly dilated. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsMultiple bilateral renal cysts, which are poorly characterized. 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. Severe left ventricular dilation with severely reduced systolic function (LVEF 25%). No evidence of underlying myocardial infarction. There is a significant amount of myocardial viability in all three coronary artery territories. 2. Mild right ventricular dilation with normal systolic function.3. Severe left atrial dilation.4. Mild protruding atheroma noted in descending thoracic aorta. 5. Mild dilation of the main pulmonary artery. 6. See extra-cardiac findings. 