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Acute myocardial infarction in a patient with dextrocardia and successful angioplasty

Bishnu H Subedi1

  • 1Division of Cardiology, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA.

Journal of Community Hospital Internal Medicine Perspectives
|January 4, 2018
PubMed

Insights

A 48-year-old man with dextrocardia experienced chest pain. An electrocardiogram (ECG) revealed ST elevations, and coronary angiography identified a blocked left anterior descending artery (LAD). The LAD was successfully treated with a drug-eluting stent.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Dextrocardia is a rare congenital condition where the heart is on the right side of the chest.
  • Atypical chest pain can be indicative of acute coronary syndrome.

Purpose of the Study:

  • To report a case of acute myocardial infarction in a patient with dextrocardia.
  • To highlight the diagnostic and interventional challenges in patients with dextrocardia.

Main Methods:

  • A 48-year-old male patient with dextrocardia presented with acute chest pain.
  • Right-sided electrocardiography (ECG) was performed, showing ST-segment elevations.
  • Coronary angiography was utilized to visualize the coronary arteries and identify occlusions.

Main Results:

  • The patient presented with atypical chest pain, suggestive of cardiac ischemia.
  • Right-sided ECG demonstrated convex upward ST elevations in leads V4 and V5.
  • Coronary angiography revealed a complete occlusion in the mid-portion of the left anterior descending artery (LAD).
  • Successful percutaneous coronary intervention (PCI) was performed with the placement of a drug-eluting stent in the LAD.

Conclusions:

  • This case demonstrates that acute coronary syndromes can occur in patients with dextrocardia.
  • Right-sided ECG can be crucial in diagnosing myocardial infarction in patients with dextrocardia.
  • Successful PCI of the LAD is feasible and effective in managing acute myocardial infarction in patients with dextrocardia.

Keywords:
DextrocardiaKartagener syndromeST-elevation myocardial infarctionangioplastycoronary angiogram

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