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. 2018 Jul 17;5(5):902–910. doi: 10.1002/ehf2.12317

Figure 2.

Figure 2

Ventilation/perfusion single‐photon emission computed tomography (V/P SPECT) and chest X‐ray (CXR) images of two patients with heart failure. (A) A patient with heart failure (HF) but no signs of pulmonary congestion. Pulmonary artery wedge pressure (PAWP) is normal. In the transversal and sagittal planes on V/P SPECT, perfusion is predominantly distributed to the dependent posterior parts of the lungs (arrows). The perfusion gradient is −1.7, which is normal. (B) The CXR shows enlargement of the heart but was otherwise regarded as negative regarding pulmonary congestion. (C) Transversal and sagittal V/P SPECT slices of the lungs of a patient with HF and pulmonary congestion. PAWP was elevated to 22 mmHg. The perfusion images show redistribution of pulmonary perfusion to the anterior parts of the lungs in the supine position (dotted arrows). The perfusion gradient is 3.2, which also supports the diagnosed pulmonary congestion. (D) The CXR shows an enlarged heart but was otherwise assessed as negative for pulmonary congestion.