A Concealed Malformation for Quinquagenarian: Dextrocardia

Abstract

Dextrocardia is a rare congenital malformation in which the heart is located in the right hemithorax, with an incidence of around 1 in 12,000. Dextrocardia usually remains asymptomatic until accidentally diagnosed through echocardiography and chest radiography, which are mostly performed for other reasons. The complex heart anatomy in dextrocardia can pose great challenges, particularly in patients requiring surgical interventions. In this case presentation, we aimed to emphasize that a multidisciplinary approach is recommended in managing patients with dextrocardia. A 54-year-old female patient arrived with nausea, vomiting, fatigue, and tremor complaints. Medical evaluations revealed bradycardia, which developed after the use of propranolol for a panic attack. The patient underwent an angiography due to the existence of non-ST elevation myocardial infarction and Wenckebach's atrioventricular block, which showed the deviation of the left coronary artery to the right and of the right coronary artery to the left, raising suspicion of dextrocardia. Chest radiography confirmed the presence of dextrocardia. The patient received the necessary treatment, since dextrocardia poses minimal risk, the patient was discharged with follow-up recommendations.