Incidental Massive Pericardial Effusion Diagnosed by Myocardial Perfusion Imaging

Abstract

A report on an unusual case of pericardial effusion and tamponade that was found incidentally on myocardial perfusion imaging. This was later confirmed by echocardiography and subsequently treated with pericardiocentesis. Two-dimensional echocardiography is still the "gold standard" for diagnosing pericardial effusion. Nuclear cardiac imaging will probably never have a primary role in the diagnosis of pericardial effusion. However, it may be helpful when the diagnosis of pericardial effusion has not been considered and when this condition is suggested by nuclear imaging findings. The echocardiogram underestimated the amount of pericardial effusion compared to myocardial perfusion imaging in this case, and in contrast to previous published reports. Further, prospective studies need to focus on the sensitivity and specificity of sestamibi nuclear scans in the qualitative and quantitative assessment of pericardial effusions.

Incidental Detection of Malignant Pleural Effusion on Sestamibi Myocardial Perfusion Scan

“…There are few reports in the literature concerning detection of pericardial effusion in the myocardial perfusion scintigraphy using 99m Tc-sestamibi [1][2][3][4][5][6], and its diagnostic criteria has been described in detail by Herzog et al [5]. They stated that a circumferential ''halo'' of diminished tracer concentration surrounding the heart (a photopenic defect) Fig.…”

“…Diagnostic methods of choice include echocardiography, CT, and MRI. However, incidentally the diagnosis of these effusions can be made with scintigraphic studies [1][2][3][4][5][6]. Reporting of these incidental findings can be important because these can sometimes result in determining previously unknown pathologies.…”

Non-Ischemic Finding on Gated SPECT Myocardial Perfussion Imaging to Explain Symptoms: Case Report

“…Fo ur pe ri car di al ef fu si on ca ses with the typi cal ap pe a ran ce of a "ha lo " of pho to pe nic are a surro un ding the he art on pla nar pro jec ti on and to mog rap hic ima ges, and a "roc kin g" mo ti on of the he art on GA TED ima ges we re re por ted by Pa tel et al, 4 As kew et al, 13 and Her zog et al, 14 with typical ap pe ran ce as men ti o ned be fo re. 4 One ca se was al so re por ted as the ec ho car di og ram had un de resti ma ted the amo unt of pe ri car di al ef fu si on com pared to myo car di al per fu si on ima ging, by Spi eth ME et al 15 In our ca se, alt ho ugh the ap pe ran ce of photo pe nic ha lo was se en aro und the he art, the roc king mo ti on of the he art was not seen on GA TED ima ges.…”

False positive stress-test in a patient with pericardial effusion

“…After the drainage of pericardial effusion, reversible defect on a stress test resolved. Cardiac catheterization revealed normal coronary arteries.Pericardial effusion as an incidental finding on a nuclear study was previously described [1,2]. However, pericardial effusion influencing reversibility on the nuclear images has not been reported.…”

“…Pericardial effusion as an incidental finding on a nuclear study was previously described [1,2]. However, pericardial effusion influencing reversibility on the nuclear images has not been reported.…”