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Published on: February 11, 2022
A Rare Case Study of Dextrocardia with Myocardial Infarction and Cerebrovascular accident in Situs Inversus Totalis
1Department of General Internal Medicine, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, Maharashtra, India.
Insights
Situs inversus totalis (SIT) patients rarely experience simultaneous myocardial infarction (MI) and stroke. This case highlights unique diagnostic challenges in managing these critical cardiovascular and neurological events in patients with mirror-image organ transposition.
Area of Science:
- Cardiology
- Neurology
- Genetics
Background:
- Situs inversus totalis (SIT) is a rare congenital condition with complete mirror-image transposition of organs.
- Simultaneous myocardial infarction (MI) and cerebrovascular accidents (stroke) in SIT patients are exceptionally rare.
- SIT presents unique diagnostic and therapeutic challenges due to reversed anatomy.
Abstract:
Situs inversus totalis (SIT) is a rare congenital condition, characterized by complete mirror-image transposition of the thoracic and abdominal organs. Although individual reports of myocardial infarction (MI) or cerebrovascular accidents in patients with SIT exist, the simultaneous occurrence of both is extremely rare and poses unique diagnostic and therapeutic challenges. We report the case of a 55-year-old female presenting with right-sided chest pain and later developing neurological deficits. Initial evaluation revealed dextrocardia and SIT on chest radiograph and abdominal ultrasound. Electrocardiogram (ECG) showed ST-segment elevation in leads V1-V4, suggestive of anterior wall MI. The diagnosis was complicated due to reversed anatomical orientation. On day 3, the patient developed left-sided weakness and computed tomography of the brain confirmed an acute infarct in the right parietal lobe. Echocardiography revealed left ventricular apical clot with reduced ejection fraction. A coronary angiogram showed double-vessel disease involving the left anterior descending artery and ramus arteries and percutaneous coronary intervention was performed. This case highlights the clinical complexity and diagnostic uncertainty in managing cardiovascular and neurological events in patients with SIT. To our knowledge, this is one of the first reported cases of concomitant MI and stroke in a patient with SIT.
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