Left Ventricular Aneurysm

This radiograph was obtained from a 70 y.o. previously well black female who presented in congestive heart failure and was diagnosed as having a massive aneurysm of the left ventricle. The left ventricular ejection fraction was measured at 9% by equilibrium radionuclide angiogram (ERNA) - a normal value would be greater than 55%. This implies that if the dilated left ventricle has an end-diastolic volume of 400 cc. (the normal is about 150 cc.) this patient would eject only 36 cc. of blood with each beat. At 75 beats per minute, that would mean the patient is generating a cardiac output of 2700 cc. (2.7 liters) with little ability to raise the output during exercise.