56 year old female with a history of COPD, Diabetes, sarcoidosis, and myocardial infarction approximately 20 years ago. Referred for vasodilator stress MRI due to recent development of chest pain, shortness of breath, and T-wave changes on ECG.MEDICATIONS: Metformin, Simvastatin, Valsartan, Fluticasone-Salmeterol, Aspirin. 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 normal in size and systolic function. The overall LV ejection fraction is 60%, the LV end diastolic volume index is 66 ml/m2 (normal range: 65+/-11), the LVEDV is 133 ml (normal range 109+/-23), the LV end systolic volume index is 57 ml/m2 (normal range 18+/-5), the LVESV is 54 ml (normal range 31+/-10), the LV mass index is 52 g/m2, and the LV mass is 104 g. There are no regional wall motion abnormalities present. 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 56%, the RV end diastolic volume index is 60 ml/m2 (normal range 69+/-14), the RVEDV is 122 ml (normal range 110+/-24), the RV end systolic volume index is 27 ml/m2 (normal range 22+/-8), and the RVESV is 54 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.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal arch 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 pericardial thickening.Extracardiac FindingsAn upper pole cyst is seen in the left kidney, which was described in an abdominal ultrasound on 6/3/2014. It is incompletely imaged on this exam.
1. No perfusion defects/ "ischemia" present during hyperemia.2. No prior myocardial infarction. The entire myocardium is viable.3. Normal LV size and systolic function (LVEF 60%).4. Normal RV size and systolic function (RVEF 56%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.