61 year old with history of AML and coronary artery disease presenting for cardiac evaluation prior to stem cell transplant. MEDICATIONS: none First Pass PerfusionDuring hyperemia, there is a perfusion defect involving the mid to basal inferior and inferoseptal walls.Viability/ Myocardial ScarThere was a non-transmural myocardial infarction involving the mid to basal inferior and inferoseptal walls. These segments have an intermediate probability of viability. The remainder of the myocardium is free of myocardial infarction and viable. Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. There is mild hypokinesis of basal inferior and inferoseptal walls. The overall LV ejection fraction is 49%, the LV end diastolic volume index is 101 ml/m2 (normal range: 74+/-15), the LVEDV is 195 ml (normal range 142+/-34), the LV end systolic volume index is 52 ml/m2 (normal range 25+/-9), the LVESV is 100 ml (normal range 47+/-19), the LV mass index is 40 g/m2, and the LV mass is 77 g. 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 60%, the RV end diastolic volume index is 90 ml/m2 (normal range 82+/-16), the RVEDV is 174 ml (normal range 142+/-31), the RV end systolic volume index is 36 ml/m2 (normal range 31+/-9), and the RVESV is 70 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is trace 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. There aorta is mildly tortuous. 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. There is "ischemia" involving the mid to basal inferior and inferoseptal walls. These segments have a non-transmural myocardial infarction and have an intermediate probability of viability. The remainder of the myocardium is free of ischemia and myocardial infarction. 2. Normal LV size with mildly reduced systolic function (LVEF 49%) with mild hypokinesis of the basal inferior and inferoseptal walls.3. Normal RV size and systolic function (RVEF 60%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.