On echocardiogram the LV function has worsened and there are new wall motion abnormalities. The left ventricle is mildly dilated. There is mild concentric left ventricular hypertrophy. The mid and distal anterior wall, anterospetum, and apex are akinetic; otherwise global hypokinesis. Left ventricular systolic function is severely reduced. The left ventricular ejection fraction is 20-25%.