73 year old man with history of lymphoma, mild LV dysfunction, referred for stress cardiac MRI prior to stem cell transplant. MEDICATIONS: ASA, lisinopril, Toprol XL. 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 mild to moderately dilated with moderately reduced systolic function. The overall LV ejection fraction is 38%, the LV end diastolic volume index is 118 ml/m2 (normal range: 74+/-15), the LVEDV is 241 ml (normal range 142+/-34), the LV end systolic volume index is 74 ml/m2 (normal range 25+/-9), the LVESV is 150 ml (normal range 47+/-19), the LV mass index is 51 g/m2, and the LV mass is 105 g. LV dysfunction is global with regional variation.Left AtriumThe left atrium is severely dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 57%, the RV end diastolic volume index is 79 ml/m2 (normal range 82+/-16), the RVEDV is 160 ml (normal range 142+/-31), the RV end systolic volume index is 34 ml/m2 (normal range 31+/-9), and the RVESV is 69 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly dilated.Aortic ValveThe aortic valve has reduced leaflet excursion with evidence of flow acceleration consistent with the diagnosis of aortic valve stenosis. Correlation with echocardiography suggested to determine the severity of aortic valve stenosis. 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. Mild to moderate LV dilation with moderately reduced systolic function (LVEF 38%).4. Normal RV size and systolic function (RVEF 57%).5. Severe left atrial dilation.6. Aortic valve stenosis noted, severity not characterized on this study. Correlation with echocardiography suggested.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.