42 y/o female with a history of hyperlipidemia, coronary artery disease status post percutaneous intervention to the right coronary artery and obtuse marginal branch of left circumflex, presenting for evaluation of coronary artery disease and cardiac function. MEDICATIONS: aspirin and clopidogrel. First Pass PerfusionDuring hyperemia, perfusion defects were present in the basal anterior, septal and inferior , mid inferior septal and antero-lateral, and apical inferior wall. Viability/ Myocardial ScarThere no late gadolinium enhancement noted. The entire myocardium is viable.Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 63%, the LV end diastolic volume index is 84 ml/m2 (normal range: 65+/-11), the LVEDV is 136 ml (normal range 109+/-23), the LV end systolic volume index is 32 ml/m2 (normal range 18+/-5), the LVESV is 51 ml (normal range 31+/-10), the LV mass index is 36 g/m2, and the LV mass is 58 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 with normal systolic function. The overall RV ejection fraction is 53%, the RV end diastolic volume index is 78 ml/m2 (normal range 69+/-14), the RVEDV is 126 ml (normal range 110+/-24), the RV end systolic volume index is 36 ml/m2 (normal range 22+/-8), and the RVESV is 59 ml (normal range 35+/-13). Right AtriumThe right atrium is not well seen. Aortic ValveThe aortic valve opens widely and there is at least mild 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 mildly dilated. The maximum diameter at the sinus of Valsalva is 45 mm. There is a left sided aortic arch with a normal brachiocephalic branching pattern.The sinus of valsalva measures 45 x 44 x 45 mmThe ST junction measures 37 x 35 mmThe ascending aorta measures 37 x 35 mmDescending thoracic aorta measures 25 x 25 mm.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. Perfusion defects were present in the basal anterior, septal and inferior , mid inferior septal and antero-lateral, and apical inferior wall.2. The entire myocardium is viable.3. Normal LV size and systolic function (LVEF 63%).4. Normal RV size and systolic function (RVEF 53%).