LV Volume / Pressure Overload

Dilated CMP Secondary to Hypertension
(Case 1)

FINDINGS
IMPRESSION
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Note: 8-year follow-up ECHO given below

Impression:

  • Moderate increased LV volume.
  • Mild reduced uptake at rest (arrows) and transient changes in the septum (small lines) - most likely functional (secondary to LBBB, 7 to 11 o'clock; apex and free anterior wall are not involved).

  • No other fixed or reversible perfusion abnormalities detected at the high cardiac workload achieved.
    Discrepancy between LV volume and perfusion abnormalities suggestive of LV volume overload condition (CMP ?, valve disease ?). ECHO
    8 years ago
  • Moderate LV enlargement and hypertrophy with moderate uniform contractile dysfunction.
  • Mild mitral regurgitation (1+)

    6 years ago

  • Moderate LV enlargement with extensive areas of apical and antroseptal akinesis. Severe reduction in global systolic function.
  • Borderline left atrial enlargement with mild mitral regurgitation (1+).

    5 years ago

  • Moderate LV enlargement with extensive areas of apical and antroseptal akinesis. Severe reduction in global systolic function.
  • Moderate left atrial enlargement with mild mitral regurgitation (1+).

    Recent

  • Moderate LV enlargement with severe reduction in global systolic function.
  • Discrete region of aneurysmal dilatation in the apex and dyskinesis of the distal septum.
  • Moderate left atrial enlargement with mild MR (1+)
  • Normal RV size and function

    Comments:
    Myocardial perfusion is only mildly abnormal in septum, all other walls appear well perfused. The repeatedly observed contractile dysfunction is therefore not due to ischemic heart disease. Hypertensive CMP is the most likely etiology (by exclusion).

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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.