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Medical Science Monitor Basic Research


Acute myocardial infarction in a patient with situs inversus totalis

Damian Kawecki, Wojciech Wojakowski, Rafał Wyderka, Andrzej Rudnik, Marek Kondys, Ewa Nowalany-Kozielska, Paweł Buszman

Am J Case Rep 2010; 11:113-115

ID: 880591

Available online: 2010-05-26

Published: 2010-05-26


Background: Case report describes a 46-year-old patient with acute myocardial infarction treated with primary PCI.
Case Report: Urgent coronary angiography revealed right-sided aortic arch and mirror image of the coronary circulation. Successful PCI was performed using right-left mirror image inversion of angiographic views. Chest X-ray showed dextrocardia, and abdominal X-ray revealed findings consistent with situs inversus.
Conclusions: The practical issue when treating patients with dextrocardia and acute coronary syndrome is the reversal of the ECG leads, right-left mirror image inversion of angiographic views, altered pads placement during the defibrillation, and cardioversion. Also, the atypical presentation with the chest pain located on the right side of the chest might lead to misdiagnosis of the acute coronary syndrome.

Keywords: PTCA, acute coronary syndrome, Situs inversus totalis, Dextrocardia