JACC. Case reports · 2026
Non-ST-Segment Elevation Myocardial Infarction in a Patient With Dextrocardia.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sánchez Brandon, Contreras Pedro, González Pamela, Domínguez Luis, Goveo Iván, López Luciano José
Аннотация
BACKGROUND: Dextrocardia with situs inversus totalis is a rare congenital anomaly that complicates diagnosis and percutaneous coronary intervention (PCI) for acute coronary syndromes due to mirror-image anatomy.
CASE SUMMARY: A 50-year-old man with situs inversus totalis presented with severe angina, syncope, and markedly elevated troponin (non-ST-segment elevation myocardial infarction). Initial electrocardiogram (ECG) showed right axis deviation and atypical R-wave progression. Lead reversal confirmed ischemic changes. Coronary angiography revealed complete right coronary artery occlusion and multivessel disease. The right coronary artery was successfully revascularized, achieving TIMI flow grade 3.
DISCUSSION: This case illustrates the rare combination of acute coronary syndrome in a patient with situs inversus. It reinforces that standard myocardial infarction management protocols must be applied with necessary, specific anatomical adaptations in both ECG interpretation and PCI technique.
TAKE-HOME MESSAGE: Accurate ECG interpretation in dextrocardia requires lead reversal, and successful PCI in situs inversus depends on adaptation of catheter selection and fluoroscopic imaging.
CASE SUMMARY: A 50-year-old man with situs inversus totalis presented with severe angina, syncope, and markedly elevated troponin (non-ST-segment elevation myocardial infarction). Initial electrocardiogram (ECG) showed right axis deviation and atypical R-wave progression. Lead reversal confirmed ischemic changes. Coronary angiography revealed complete right coronary artery occlusion and multivessel disease. The right coronary artery was successfully revascularized, achieving TIMI flow grade 3.
DISCUSSION: This case illustrates the rare combination of acute coronary syndrome in a patient with situs inversus. It reinforces that standard myocardial infarction management protocols must be applied with necessary, specific anatomical adaptations in both ECG interpretation and PCI technique.
TAKE-HOME MESSAGE: Accurate ECG interpretation in dextrocardia requires lead reversal, and successful PCI in situs inversus depends on adaptation of catheter selection and fluoroscopic imaging.