Impression:
Moderately increased LV volume (2+).
Small nontransmural MI in the apical inferior wall and in the septum (arrows) (4/25 segments).
Moderate severe ischemia in the apex, apical two thirds of septum, and apical inferior wall (small lines) (6/25 segments).
Discrepancy between LV volume and rest perfusion abnormalities suggestive of LV volume overload condition (CMP ?, valve disease ?).
Comments:
The permanent myocardial injury is mild, involves a small volume and should not lead to LV dilatation. The patient has a known moderate to severe AS, one would therefore expect LV hypertrophy. The observed LV dilatation is with all likelihood myocardial decompensation secondary to longstanding LVH.
