Myocardial infarction

Case contributed by Tim Luijkx

Presentation

Known coronary artery disease of multiple coronaries. Silent ischemia on ECG. Fractional flow reserve (FFR) non-significant. No symptoms.

Patient Data

Age: 55 years
Gender: Male
mri

Dimensions:
- LV: 64 mm
- RV: 43 mm
- interventricular septum: 11 mm

Hypokinesia and wall thinning with increased trabeculation, most notably of the lateral wall of the mid-left ventricle towards the apex. Good contraction at the basal level. No valvular insufficiencies. 

Late gadolinium enhancement of the lateral LV wall in keeping with infarction. 

Measurements:
LV EDV: 290 mI (123 ml/m2)
LV ESV: 174 ml  (76 ml/m2)
LV stroke volume: 116 ml (51 ml/m2)
LV EF: 40%
LV CO: 7.5 l/ min

RV EDV: 208 ml
RV ESV: 91 ml
RV stroke volume: 118 ml
RV EF: 56%
RV CO: 7.6 l/min

Conclusion:
Infarction of the lateral LV wall with slight left ventricular hypertrophy with decreased function (ejection fraction 40%). 

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