60 year old male with a history of three vessel coronary artery disease, congestive heart failure, Hypertension, Diabetes, and CVA. DES placed in RCA in October 2014. Referred for cardiovascular MRI to evaluate for function and scar burden. Left VentricleThe left ventricle is normal in size with severely reduced systolic function. There is dyssynergy with a regional wall motion abnormality and myocardial thinning in the basal and mid inferolateral and lateral walls. The overall LV ejection fraction is 30%, the LV end diastolic volume index is 89 ml/m2 (normal range: 74+/-15), the LVEDV is 199 ml (normal range 142+/-34), the LV end systolic volume index is 62 ml/m2 (normal range 25+/-9), the LVESV is 138 ml (normal range 47+/-19), the LV mass index is 71 g/m2 (normal range 85+/-15), and the LV mass is 159 g (normal range 164+/-36). There is late gadolinium enhancement > 50% wall thickness seen in the basal and mid inferolateral and lateral walls. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 41%, the RV end diastolic volume index is 64 ml/m2 (normal range 82+/-16), the RVEDV is 142 ml (normal range 142+/-31), the RV end systolic volume index is 37 ml/m2 (normal range 31+/-9), and the RVESV is 83 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 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 IVC is normal sized.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. Severe LV systolic dysfunction2. Inferolateral and lateral wall motion abnormality with > 50% transmural extent c/w non-viability.