ST-Elevation Myocardial Infarction in Situs Inversus Dextrocardia: A Case Report

Abstract

SummaryST-elevation myocardial infarction (STEMI) in situs inversus dextrocardia is a rare combination and poses many challenges in terms of diagnosis and management. These include the early detection of dextrocardia as well as the interpretation of the ECG. In addition, percutaneous coronary intervention could be challenging in the setting of dextrocardia because of diffi culty in cannulating the coronary arteries, selection of catheters, catheter manipulation, image acquisition and interpretation.

Galaktozemi̇ Ve Si̇tus İnversus Totali̇s Beraberli̇ği̇: Nadi̇r Bi̇r Olgu Sunumu

“…Altmış sekiz yaşındaki bir erkek hastada halsizlik, gece terlemesi, abdominal distansiyon ve hassasiyet ile hastane başvurusunda çekilen akciğer grafisinde kalbinin sağda yerleştiği fark edilmiş ve kronik myeloid lösemiyle eş zamanlı olarak tesadüfen situs inversus totalis tanısı bildirilmiştir (8). Kırkbeş yaşındaki tip 2 diyabetes mellitus ve bronşial astım tanıları ile uzun süre izlenen bir hastada ani başlayan göğüs ağrısı, terleme ve takipne nedeniyle hastaneye başvurusunda çekilen telegrafisinde miyokard enfarktüsüne eşlik eden dekstrokardi saptanmıştır (9). 2017'de Sivri ve arkadaşları (10), bir kalıtsal metabolik hastalık olan Fankoni-Bickel sendromu ile situs inversus totalis anomalisinin birlikteliğini rapor etmişlerdir.…”

A case of percutaneous coronary intervention of the right coronary artery in a situs inversus patient with foreshortening of lesion revealed by intravenous ultrasound imaging technology

“…It can be difficult to identify myocardial infarcts in these patients, especially if dextrocardia presence is unknown, as presenting complaint may be right-sided chest pain with possible radiation to the right shoulder and arm [ 2 ]. EKG interpretation can also be misleading if dextrocardia is unknown at time of test [ 3 ]. Guidelines for intervention are the same as in non-dextrocardia patients, but the operator must take into account the unique anatomical challenge that comes with transposition of the heart and coronaries to ensure optimal benefits [ 1 ].…”

Left Lateral View for PCI Treatment of Inferior STEMI in a Patient with Dextrocardia

“…Electrocardiogram in patients with dextrocardia has poor R-wave progression in the precordial leads and both P-waves, as well as QRS complexes that usually have right axis deviation ( 3 ). In addition, P-waves on standard electrocardiograms are inverted ( 4 ). It is recommended that in patients with established or suspected dextrocardia, the ECG electrodes be reversed.…”