A 47 year old male with diabetes, hypertension, hyperlipidemia, coronary artery disease, s/p myocardial infarction in 2011 with PCI and stent placement to the circumflex artery. In a repeat cath, the circumflex stent was occluded and stenosis in the right coronary artery was noted and PCI with stent placement was performed.MEDICATIONS: regadenoson, aminophylline, carvedilol, victoza, losartan, metformin, crestor. Viability/ Myocardial ScarThere is transmural late gadolinium enhancement noted in the basal and mid segments of the infero-lateral wall consistent with prior myocardial infarction. The rest of the myocardium is viable.Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 54%, the LV end diastolic volume index is 71 ml/m2 (normal range: 74+/-15), the LVEDV is 151 ml (normal range 142+/-34), the LV end systolic volume index is 33 ml/m2 (normal range 25+/-9), the LVESV is 69 ml (normal range 47+/-19), the LV mass index is 55 g/m2, and the LV mass is 115 g. There is hypokinesis of the basal infero-lateral wall. Left AtriumThe left atrium is upper limits normal. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 58%, the RV end diastolic volume index is 62 ml/m2 (normal range 82+/-16), the RVEDV is 130 ml (normal range 142+/-31), the RV end systolic volume index is 26 ml/m2 (normal range 31+/-9), and the RVESV is 54 ml (normal range 54+/-17).Right AtriumThe right atrium is normal.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,two on the RT and two on the left.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe SVC and IVC drain normally into the right atrium.PericardiumThere is no pericardial effusion.
1. The left ventricle is normal in size with normal systolic function, LVEF is 54%. There is hypokinesis of the basal infero-lateral wall. 2. There is near transmural late gadolinium enhancement noted in the basal and mid segments of the infero-lateral wall consistent with myocardial infarction. The rest of the myocardium is viable.3. The right ventricle is normal in size with normal systolic function, RVEF is 58%. 4. The left atrium is upper limits normal size. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.