Situs inversus and acute coronary syndrome

Area of Science:

• Cardiology
• Medical Imaging
• Interventional Cardiology

Background:

• Dextrocardia, a rare condition with a 1 in 10,000 incidence, complicates acute coronary syndromes.
• Percutaneous coronary intervention (PCI) in dextrocardia patients poses unique anatomical and procedural challenges.
• Previous reports detail successful single-vessel PCI, but multi-vessel intervention remains less explored.

Observation:

• A male patient with dextrocardia and situs inversus presented with symptoms suggestive of acute coronary syndrome.
• Standard diagnostic and interventional procedures were adapted due to the patient's atypical cardiac anatomy.
• The patient underwent successful percutaneous coronary intervention with stent deployment in two coronary arteries.

Findings:

• This is the first reported case of successful two-vessel percutaneous coronary intervention in a patient with dextrocardia and situs inversus.
• Post-intervention angiographic results showed successful stent deployment and restored coronary blood flow.
• Unexpectedly, the hemodynamic and electrocardiographic changes post-intervention did not align with typical outcomes.

Implications:

• This case expands the interventional possibilities for managing acute coronary syndromes in patients with dextrocardia and situs inversus.
• It highlights the need for tailored approaches and awareness of potential atypical responses to interventions in rare cardiac anatomies.
• Further research into the physiological responses following PCI in situs inversus patients is warranted to understand the observed discrepancies.