Massive left pleural effusion resulting in false-positive myocardial perfusion

In summary, raw data images of our patient showed 2 findings: (1) displacement of the heart away from its normal cardiac position and (2) massive left pleural effusion. The abnormal cardiac position and massive left pleural effusion alerted us to abnormal left ventricular perfusion, and false-positive myocardial perfusion was confirmed by the second gated cardiac SPECT acquisition after clearance of pleural effusion. Thus an abnormal position of the heart within the chest cavity and massive left pleural effusion may potentially cause SPECT perfusion artifacts. Raw data images should be included as a part of the interpretation routine. Copyright © 2005 by the American Society of Nuclear Cardiology.