Impression:
Moderately increased LV volume.
Mild nontransmural MI in the anterior septum and the anterior wall (white arrows) (5/25 segments), reverse changes with stress (LAD territory).
Moderate severe nontransmural MI in the inferior lateral wall (green arrows) (5/25 segments) (RCA territory).
No stress-induced ischemia.
Discrepancy between perfusion abnormalities and LV volume suggesting of LV volume overload condition (CMP ?, valve disease ?).
Mild-to-moderate increased RV uptake indicating RV pressure overload (pink arrows with "RV").
ECHO
Mild LV enlargement; EF estimated at 45%; distal septal and apical hypokinesis.
Comments:
The LV volume is moderately increased, but more so than one would be expect from the mild-to-moderate severe myocardial injuries and corresponding mild reduced LVEF.
The aortic valve was replaced due to mixed AS / AR (moderate severe AS, mild AR) two years prior to the study.
ECHO now show no regurgitation and no functional stenosis (peak velocity 2.5 m/sec).
The LV dilatation is with all likehood remains from the preoperative situation (no volume compensation took place, the valve replacement may have been performed somewhat late in the history of this patient's aortic valve disease).
