66 year old woman with history of dyslipidemia and polycythemia vera who presents with months of dyspnea on exertion with associated chest tightness. MEDICATIONS: aspirin, omega 3 fatty acid, prevacid First Pass PerfusionDuring hyperemia, no perfusion defects were present. There was significant dark rim artifact. 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 with hyperdynamic systolic function. The overall LV ejection fraction is 69%, the LV end diastolic volume index is 78 ml/m2 (normal range: 65+/-11), the LVEDV is 127 ml (normal range 109+/-23), the LV end systolic volume index is 24 ml/m2 (normal range 18+/-5), the LVESV is 39 ml (normal range 31+/-10), the LV mass index is 45 g/m2, and the LV mass is 73 g. There are no regional wall motion abnormalities present. There is no significant iron overload of the myocardium.Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 67%, the RV end diastolic volume index is 30 ml/m2 (normal range 69+/-14), the RVEDV is 98 ml (normal range 110+/-24), the RV end systolic volume index is 20 ml/m2 (normal range 22+/-8), and the RVESV is 32 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve is trileaflet, opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve leaflets are mildly thickened. The valve opens widely with trace 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 brachiocephalic 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 obvious pericardial disease.Extracardiac FindingsThere is heterogenous hypointensity of the bone marrow likely related to the patient's hematologic history. 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. No true perfusion defects/ "ischemia" present during hyperemia.2. No prior myocardial infarction. The entire myocardium is viable.3. Normal LV size and systolic function (LVEF 69%).4. Normal RV size and systolic function (RVEF 67%).