• J Emerg Med · May 2020

    Review Case Reports

    ST-Elevation Myocardial Infarction in a Patient Having Dextrocardia with Situs Inversus.

    • Stephen Elliott, David Levy, and Howard Brown.
    • Department of Emergency Medicine, Good Samaritan Hospital Medical Center, West Islip, New York.
    • J Emerg Med. 2020 May 1; 58 (5): 797-801.

    BackgroundDextrocardia with situs inversus is a rare genetic condition in which the heart and internal organs are positioned on the opposite side of the body. Diagnosing and treating acute myocardial infarction correctly in a patient with dextrocardia is a difficult task.Case ReportWe present the case of an acute anterior wall ST elevation myocardial infarction (STEMI) in a patient with dextrocardia with situs inversus diagnosed after a lead reversal electrocardiogram (ECG). The patient then successfully underwent percutaneous coronary intervention and subsequent multivessel coronary artery bypass grafting. We discuss the original diagnosis and decision-making, clinical features, ECG characteristics, and disposition of the patient, as well as a review of the relevant literature. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians must identify and recognize the typical ECG of dextrocardia, especially when presenting with pathology, as its identification can lead to proper diagnosis and treatment.Copyright © 2020 Elsevier Inc. All rights reserved.

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