ACUTE INFERIOR MYOCARDIAL INFARCTION IN DEXTROCARDIA- DIAGNOSTIC AND THERAPEUTIC CHALLENGE

Abstract

Dextrocardia with situs inversus has an incidence of 1 in 10,000 and is a rare cardiac anomaly in which the heart is located in the right hemithorax with the axis directed to the right and caudally. Patients with dextrocardia present a diagnostic challenge, especially in the setting of acute coronary syndrome. The left circumflex artery (LCx) is the least frequent culprit artery for acute myocardial infarction (AMI) in the general population. An electrocardiogram (ECG) has very low sensitivity for detecting ST-segment elevation myocardial infarction (STEMI) if the culprit lesion is in the LCx. The coexistence of dextrocardia and LCx occlusion increases the difficulty of diagnosis via ECG. We herein present a case of dextrocardia and LCx-related STEMI. Coronary heart disease and AMI occur at the same frequency in patients with dextrocardia as in the general population. Notably, given the rarity of dextrocardia, only a few reports to date have described the existence of AMI as a result of acute LCx occlusion in a patient with dextrocardia.

Keywords

• Acute myocardial infarction
• Dextrocardia
• Primary angioplasty.

References

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