ECG Diagnosis: Dextrocardia

Mozayan, Cameron; Levis, Joel T.

doi:10.7812/tpp/18.244

Cited by 12 publications

(6 citation statements)

References 7 publications

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“… 11 Leads placed in a mirror location may provide reliable ECG data for patients with dextrocardia. 14 In the present case, the ideal position of the catheter tip was discovered by reversing lead II of the intracavitary ECG. Post-procedure chest radiography revealed that the tip of the catheter was positioned in the inferior vena cava and located 3.01 cm below the tracheal carina.…”

Section: Discussionmentioning

confidence: 55%

Insertion of a totally implantable vascular access device in a patient with dextrocardia and colon cancer: a case report

Dong,

Huang,

Zhang

et al. 2023

J Int Med Res

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Colon cancer in patients with situs inversus totalis is rarely associated with dextrocardia, and chemotherapy is commonly used for treatment. Central venous access devices are used to administer intravenous fluids and chemotherapy in patients with colon cancer. Compared with peripherally inserted central catheters and Hickman-type tunneled catheters, totally implantable vascular access devices (TIVADs) are safer and more effective. However, positioning the catheter tip may be challenging in patients with dextrocardia and situs inversus. We herein describe a novel case involving a patient with dextrocardia and colon cancer who was treated by TIVAD insertion with intracavitary electrocardiography-aided tip localization.

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Section: Discussionmentioning

confidence: 55%

Insertion of a totally implantable vascular access device in a patient with dextrocardia and colon cancer: a case report

Dong,

Huang,

Zhang

et al. 2023

J Int Med Res

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“…In patients with a true dextrocardia in situs inversus, EKG can reveal right axis deviation, a negative QRS complex, inverted P and T waves in lead I, biphasic T waves, and progressively decreasing R-wave amplitude from leads V1 to V6 [4]. These findings were notably absent in this patient.…”

Section: Dextroposition or Dextrocardia?mentioning

confidence: 57%

Recurrent Hiatal Hernia Resulting in Rightward Mediastinal Shift: Diagnostics in Cardiology and Clinical Pearls

Mehra¹,

Alvarado²,

Diaz-Martell³

et al. 2021

Cureus

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On radiographic imaging, the finding of a right-sided heart location can be due to multiple etiologies and may be congenital or acquired. We present the case of a 71-year-old male with a self-reported past medical history of hiatal hernia and previously diagnosed dextrocardia. The patient experienced cardiovascular intervention following an ST-elevation myocardial infarction. In the cardiac workup, a low-voltage normal electrocardiogram confirmed dextroposition of the heart due to significant herniation of gastric contents into the thoracic cavity. This gentleman had presumably been diagnosed with dextrocardia, a right-left reversal of heart anatomy and electrophysiology, based on imaging and incomplete workup.Dextroposition refers to a rightward shift of the mediastinum with no changes in orientation of cardiac anatomy, and therefore unchanged directional orientation of conduction. This is an important distinction from dextrocardia, a mirror-image reversal of the cardiac chambers and heart location in the chest wall, such as that due to congenital ciliary dysfunction. A sliding hernia is an uncommon cause of the rightward mediastinal shift, with few such cases documented in the literature, and cardiovascular manifestations of hiatal hernias are discussed. This case exemplifies the role of an electrocardiogram in distinguishing between dextrocardia and dextroposition for accurate diagnosis and management.

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“…ECG programmers have struggled for years to produce algorithms to detect such diagnoses. 2 It is important that clinicians develop proficiency in being able to differentiate dextrocardia, limb lead reversal, and pseudodextrocardia.…”

Section: Discussion/rationalementioning

confidence: 99%