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Published on: February 16, 2011
Acute myocardial infarction in dextrocardia - A diagnostic and therapeutic challenge. Can dextrocardia be a risk
Abhishek Rathore1, Chikkarasinakere Marilinge Gowda Somashekar1, Kanchanahalli Siddegowda Sadananda1
1Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Science and Research, Bangalore, India.
Insights
Dextrocardia complicates acute myocardial infarction diagnosis and treatment. Specialized electrocardiogram lead reversal and coronary intervention techniques are crucial for successful management in these rare cases.
Area of Science:
- Cardiology
- Medical Imaging
- Interventional Cardiology
Background:
- Dextrocardia presents diagnostic and interventional challenges in acute myocardial infarction due to atypical cardiac anatomy.
- The role of dextrocardia as an independent risk factor for coronary artery disease remains incompletely understood.
Abstract:
Acute myocardial infarction in dextrocardia may present several challenges either in electrocardiographic diagnosis or coronary intervention or both, due to abnormal location of the heart, mirror images o the aorta and its branches, and abnormal coronary origin and orientation. Also, dextrocardia as a risk factor for coronary artery disease is less well established. We report the case of a young patient with dextrocardia and situs inversus without any risk factor who presented with acute extensive anterior wall myocardial infarction diagnosed after lead reversal and who successfully underwent coronary intervention using "double inversion technique". <Learning objective: Dextrocardia imposes a big challenge in diagnosing acute myocardial infarction on electrocardiography (ECG). Both limb and precordial leads should be reversed to reveal all ECG changes. Also because of the unfamiliar anatomy of coronaries and great vessels, double inversion technique is useful during the intervention. It is not well-established whether dextrocardia can be a risk factor for myocardial infarction.>.
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