59 year old man with history of DM1, CAD referred for stress cardiac MRI to evaluate for ischemia. MEDICATIONS: ASA, Lipitor, Bumex, Eplerenone, labetalol First Pass PerfusionDuring hyperemia, no perfusion defects were present. A prominent dark rim artifact was noted. 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 normal systolic function. The overall LV ejection fraction is 65%, the LV end diastolic volume index is 101 ml/m2 (normal range: 74+/-15), the LVEDV is 233 ml (normal range 142+/-34), the LV end systolic volume index is 36 ml/m2 (normal range 25+/-9), the LVESV is 82 ml (normal range 47+/-19), the LV mass index is 65 g/m2, and the LV mass is 150 g. There are no regional wall motion abnormalities present. Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 69%, the RV end diastolic volume index is 79 ml/m2 (normal range 82+/-16), the RVEDV is 183 ml (normal range 142+/-31), the RV end systolic volume index is 24 ml/m2 (normal range 31+/-9), and the RVESV is 56 ml (normal range 54+/-17).Right AtriumThe right atrium is moderately dilated.Aortic ValveThe aortic valve opens widely and there is no significant 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 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 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. 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 65%) without evidence of underlying fibrosis, inflammation, or infiltration. 4. Normal RV size and systolic function (RVEF 69%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.