Diagnosis of pericardial effusion and its effects on ventricular function using gated Tc-99m sestamibi perfusion SPECT.

Pericardial effusion is a common disorder associated with a variety of medical disorders. Diagnostic methods of choice include echocardiography, CT, and MRI. However, diagnosing pericardial effusion with radionuclides is uncommon. A pericardial effusion under pressure may result in tamponade and hemodynamic compromise, which constitutes a cardiac emergency, necessitating emergency intervention with pericardiocentesis or pericardiotomy. Presented is an unusual case of a patient who was referred to the nuclear cardiology laboratory for evaluation of atypical chest pain using stress and rest Tc-99m sestamibi perfusion SPECT. The patient had a large pericardial effusion evident on planar projection images and tomograms. From the gated perfusion study, the authors were able to evaluate left and right ventricular function and to exclude cardiac tamponade because there was no evidence of diastolic collapse of the right ventricle.