65 year old woman with chest pain/dyspnea, referred for evaluation of underlying ischemia. MEDICATIONS: ASA, pravastatin, insulin First Pass PerfusionDuring hyperemia, no perfusion defects were present.Viability/ Myocardial ScarThere is no late gadolinium enhancement noted to suggest myocardial infarction. The entire myocardium is viable.Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 68%, the LV end diastolic volume index is 73 ml/m2 (normal range: 65+/-11), the LVEDV is 150 ml (normal range 109+/-23), the LV end systolic volume index is 23 ml/m2 (normal range 18+/-5), the LVESV is 48 ml (normal range 31+/-10), the LV mass index is 38 g/m2, and the LV mass is 78 g. There are no regional wall motion abnormalities present. There is no evidence of underlying myocardial fibrosis, inflammation, or infiltration. Native myocardial T1 time is within normal limits.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 64%, the RV end diastolic volume index is 64 ml/m2 (normal range 69+/-14), the RVEDV is 132 ml (normal range 110+/-24), the RV end systolic volume index is 23 ml/m2 (normal range 22+/-8), and the RVESV is 48 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation. There is moderate mitral annular calcification extending onto the posterior leaflet.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 moderately dilated. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is a trivial pericardial effusion.Extracardiac FindingsThe esophagus is patulous. This 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. Normal LV size and systolic function (LVEF 68%) without evidence of prior myocardial infarction or other infiltrative, inflammatory, or fibrosing process. There is mild concentric left ventricular hypertrophy.3. Normal RV size and systolic function (RVEF 64%).4. Moderate dilation of the main pulmonary artery.5. Patulous esophagus.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.