Related Experiment Video
Updated: Dec 12, 2025

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Mirror-image dextrocardia: why is the apex impulse not on the right?
1Electrocardial Center, First Affiliated Hospital, Jinzhou Medical University, Jinzhou, China.
Abstract:
This article presents the case of an 11-year-old girl with a history of Fortan surgery who presented to the authors' department with shortness of breath, orthopnea, and cyanosis. Electrocardiography (ECG) was indicative of mirror-image dextrocardia despite location of the apex impulse on the left. Echocardiography suggested mirror-image dextrocardia accompanied by levoversion, a large atrial septal defect and left ventricular atresia (functional single atrium and single ventricle), and right ventricular hypertrophy. ECG with corrected leads placement showed a sinus rhythm, biatrail enlargement, and right ventricular hypertrophy. Based on echocardiography and medical history, the case was rediagnosed as mirror-image dextrocardia with levoversion.
Related Concept Videos
Cardiovascular System Abnormal Findings II: Auscultation
Abnormal Heart Sounds
Gallops:
Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
Assessment of apical pulse
Assessing the apical pulse is a critical nursing procedure, particularly indicated for:
Location and Orientation of the Heart
Directional Terms
Development of the Heart
As the embryo undergoes lateral folding, these paired tubes approach each other, merging into a single primitive heart...

