Dextrocardia With Situs Inversus Totalis in an Adult Nigerian: a Case Report

Abstract

Situs inversus with dextrocardia is the complete inversion of position of the thoracic and abdominal viscera. It may be isolated or associated with malformations, especially cardiac or alimentary. It may be discovered in infancy because of associated anomalies but often remains asymptomatic and discovered by chance in adult life. We report a 69 year old Nigerian woman found to have dextrocardia with situs inversus totalis while presenting for treatment for a totally unrelated problem. Her chest radiograph was however erroneously marked by the radiographer as normal resulting in a wrong report. The findings from an electrocardiogram and echocardiography confirmed the location of the heart in the right hemithorax and an abdominal sonogram showed the liver and gall bladder on the left side of the abdomen while the stomach and spleen were located on the right side. This report underscores the need for routine screening by individuals so that such congenital anomalies can be identified and surgical diagnoses in such patients made correctly to prevent surgical complications.

The role of electrocardiogram in the diagnosis of dextrocardia with mirror image atrial arrangement and ventricular position in a young adult Nigerian in Ile-Ife: a case report

“…Dextrocardia is one of the cardiac anomalies that presents itself with unusual and specific electrocardiographic features which include inversion of P waves in leads I and aVL, dominant S waves in leads I and V1 to V6, reversed R wave progression in chest leads, low voltage QRS axis in V4 to V6, extreme QRS axis, flattened T waves in V4 to V6 and aVR and inverted T waves in lead I and aVL. These findings were present in our patient and were consistent with ECG findings of dextrocardia in previous studies [3, 4]. A comparison between a chest X-ray of our patient (Fig.…”

“…4b) of another young man of the same age group grossly demonstrated the mirror image nature of dextrocardia. In Nigeria, the incidence of dextrocardia is largely unknown but a few cases have been reported [3, 4, 6]. According to a retrospective chart review at Children’s and Women’s Health Centre of British Columbia in Vancouver, Canada, based on a population-based study of cardiac malformations and outcomes associated with dextrocardia between 1 January 1985 and 31 December 2001, the incidence of dextrocardia was estimated to be 1 in 12,019 pregnancies [10].…”

“…Dextrocardia with situs inversus occurs at birth but its diagnosis may be in adulthood. The diagnosis can be made through clinical evaluation, electrocardiogram (ECG), chest X-ray and abdominal ultrasonography, echocardiography and computed tomography (CT) [3–5]. In a few cases, diagnoses were made at autopsy or during dissection of cadavers [6, 7].…”