A phase-rotation acquisition scheme is able to separate different signals in PRESS. In this work phase-rotation PRESS measurements were complemented by simulations to assess origins of spectral distortions in cardiac spectroscopy. Simulations show that, when using a phase-rotation acquisition scheme for PRESS without spoilers, more motion is acceptable when pulses are better calibrated. However, because of non-ideal pulse profiles, spoilers cannot be fully omitted if moving tissue is studied. It is shown that phase-rotation acqusition can, by combining simulations and measurements, be used as an elegant tool to investigate spectral distortions and optimize sequence parameters in PRESS of moving tissue.