71 y/o man with CAD with known chronic total occlusion to the right coronary artery. He presents for evaluation of left ventricular systolic function and myocardial viability. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function . The overall LV ejection fraction is 53%, the LV end diastolic volume index is 75 ml/m2 (normal range: 74+/-15), the LVEDV is 155 ml (normal range 142+/-34), the LV end systolic volume index is 35 ml/m2 (normal range 25+/-9), the LVESV is 73 ml (normal range 47+/-19). There is inferior and inferolateral hypokinesis. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.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 68 ml/m2 (normal range 82+/-16), the RVEDV is 142 ml (normal range 142+/-31), the RV end systolic volume index is 30 ml/m2 (normal range 31+/-9), and the RVESV is 62 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly enlarged.Aortic ValveThe aortic valve opens widely and there is trace aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The ascending aortic size is 3.9 cm.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 drain normally into the right atrium.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. The left ventricle is normal in size with mildly reduced systolic function (LVEF 53%). There is inferior and inferolateral hypokinesis. There is LV dyssynergy.2. There is no late gadolinium enhancement which suggest complete viability in the hypocontractile segments.3. The right ventricle is normal in size and systolic function (RVEF 56%). 