RV Pressure Overload

Restrictive Pulmonary Disease

FINDINGS
IMPRESSION
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Impression:

  • Moderately increased LV volume (2+).

  • Nontransmural apical MI (arrows) with moderate severe ischemia in the residual myocardium and adjacent apical lateral wall (white lines) (4/25 segments) (LAD territory).

  • Moderate severe ischemia in the inferior wall and adjacent posterior septum (green lines) (5/25 segments) (RCA territory).

    Note:
    Discrepancy between the degree of LV dilatation and the resting perfusion abmormalities suggestive of LV volume overload condition (CMP ?, valve disease ?).

  • Markedly increased RV uptake (3+).

    Coronary angiography:

  • RCA - proximal 80-90% stenosis
  • LAD - moderate to severe stenosis in the middle portion
  • LCX - mild stenosis

    Echocardiography:

  • MR (3+)
  • LVEF=25%

    Cardiac catheterization:

  • PCW=19
  • PAP=59/11

    Comment:
    The increased LV volume is probably secondary to the high grade MR.
    The increased RV uptake is secondary to a combination of severe restrictive lung disease and the MR with backward failure.

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    Atlas of Myocardial Perfusion SPECT
    © Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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    Initiated: Nov 19, 1995. Last updated: April 26, 1999.