57 year old with history of becker muscular dystrophy and heart transplant in 2012 presenting for routine surveillance of transplanted heart. MEDICATIONS: pravastatin, prednisone, tacrolimus, terazosin, valsartan First Pass PerfusionDuring hyperemia, no perfusion defects were present. Notably in the basal septum there is intermittent low signal which is most consistent with 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 and systolic function. The overall LV ejection fraction is 71%, the LV end diastolic volume index is 45 ml/m2 (normal range: 74+/-15), the LVEDV is 97 ml (normal range 142+/-34), the LV end systolic volume index is 13 ml/m2 (normal range 25+/-9), the LVESV is 28 ml (normal range 47+/-19), the LV mass index is 45 g/m2, and the LV mass is 97 g. There are no regional wall motion abnormalities present. No intracardiac thrombus.Left AtriumThe left atrium is consistent with transplant. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 58%, the RV end diastolic volume index is 48 ml/m2 (normal range 82+/-16), the RVEDV is 103 ml (normal range 142+/-31), the RV end systolic volume index is 21 ml/m2 (normal range 31+/-9), and the RVESV is 44 ml (normal range 54+/-17).Right AtriumThe right atrium is consistent with transplant.Aortic ValveThe aortic valve opens widely and there is no significant 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 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 pericardial effusion.Extracardiac FindingsPost surgical findings consistent with previous heart transplant.
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 71%).4. Normal RV size and systolic function (RVEF 58%).