Complete right-to-left shunt on lung perfusion SPECT results in the detection of a persistent left vena cava superior draining to the left atrium

In order to exclude acute pulmonary embolism, a lung perfusion scintigraphy was performed in a 53-year-old male, with a history of Fallot’s tetralogy. He had been immobilized because of a tibial fracture and complained of worsening chest pain and dyspnea