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