Limits...
Dextrocardia and asplenia in situs inversus totalis in a baby: a case report.

Kumar A, Singh MK, Yadav N - J Med Case Rep (2014)

Bottom Line: It may be isolated or associated with malformations, especially cardiac and/or alimentary.Only a small number of cases have been reported from India.The findings of an electrocardiogram and echocardiography confirmed the location of her heart in the right hemithorax and an abdominal sonogram showed her liver and gall bladder in midline of her abdomen whereas her stomach was located more towards the right side, her spleen was absent.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, S, N, Medical College, Agra Pin Code-282002, India. abnish23@gmail.com.

ABSTRACT

Introduction: Situs inversus with dextrocardia is the complete inversion of position of the thoracic and abdominal viscera. It may be isolated or associated with malformations, especially cardiac and/or alimentary. It may be discovered in infancy because of associated anomalies but often remains asymptomatic and discovered incidentally in adult life. Only a small number of cases have been reported from India.

Case presentation: We report the case of a 7-month-old Indo-Aryan baby girl found to have dextrocardia with situs inversus totalis who presented with fever, cough and respiratory distress. A chest X-ray showed her heart in the right hemithorax with the cardiac apex pointing towards the right. The findings of an electrocardiogram and echocardiography confirmed the location of her heart in the right hemithorax and an abdominal sonogram showed her liver and gall bladder in midline of her abdomen whereas her stomach was located more towards the right side, her spleen was absent.

Conclusions: Situs inversus totalis, although a rare condition, should be sought for when clinical and radiologic findings indicate dextrocardia, especially as it may be an incidental finding. Doctors should encourage routine medical examination for their patients which could help identify this anomaly, thereby preventing wrong diagnosis and possibly death due to delay in management.

Show MeSH

Related in: MedlinePlus

Electrocardiography showing inverted p wave in lead I.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4289310&req=5

Fig2: Electrocardiography showing inverted p wave in lead I.

Mentions: A chest X-ray posteroanterior view (Figure 1) showed her heart in the right hemithorax with the base to apex axis pointing towards the right. Her lung fields were clear. Her thoracic cage was normal. Electrocardiography (ECG) showed inverted p wave in lead I and positive QRS complex (Figure 2), positive p wave in lead avR, inverted p wave in avL and reverse progression of R wave in leads V1 to V6 (Figure 3); ECG tracing with reversed limb leads revealed positive p in lead I. Echocardiography demonstrated dextrocardia, inferior vena cava (IVC) and aorta on right side, dilated right ventricle and right atrium, large ostium primum atrial septal defect (ASD), large ventricular septal defect (VSD) at perimembranous position with bidirectional shunt, transposition of great arteries (TGA), severe aortic regurgitation (AR) and severe subvalvular pulmonary stenosis (PS; Figure 4).Figure 1


Dextrocardia and asplenia in situs inversus totalis in a baby: a case report.

Kumar A, Singh MK, Yadav N - J Med Case Rep (2014)

Electrocardiography showing inverted p wave in lead I.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4289310&req=5

Fig2: Electrocardiography showing inverted p wave in lead I.
Mentions: A chest X-ray posteroanterior view (Figure 1) showed her heart in the right hemithorax with the base to apex axis pointing towards the right. Her lung fields were clear. Her thoracic cage was normal. Electrocardiography (ECG) showed inverted p wave in lead I and positive QRS complex (Figure 2), positive p wave in lead avR, inverted p wave in avL and reverse progression of R wave in leads V1 to V6 (Figure 3); ECG tracing with reversed limb leads revealed positive p in lead I. Echocardiography demonstrated dextrocardia, inferior vena cava (IVC) and aorta on right side, dilated right ventricle and right atrium, large ostium primum atrial septal defect (ASD), large ventricular septal defect (VSD) at perimembranous position with bidirectional shunt, transposition of great arteries (TGA), severe aortic regurgitation (AR) and severe subvalvular pulmonary stenosis (PS; Figure 4).Figure 1

Bottom Line: It may be isolated or associated with malformations, especially cardiac and/or alimentary.Only a small number of cases have been reported from India.The findings of an electrocardiogram and echocardiography confirmed the location of her heart in the right hemithorax and an abdominal sonogram showed her liver and gall bladder in midline of her abdomen whereas her stomach was located more towards the right side, her spleen was absent.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, S, N, Medical College, Agra Pin Code-282002, India. abnish23@gmail.com.

ABSTRACT

Introduction: Situs inversus with dextrocardia is the complete inversion of position of the thoracic and abdominal viscera. It may be isolated or associated with malformations, especially cardiac and/or alimentary. It may be discovered in infancy because of associated anomalies but often remains asymptomatic and discovered incidentally in adult life. Only a small number of cases have been reported from India.

Case presentation: We report the case of a 7-month-old Indo-Aryan baby girl found to have dextrocardia with situs inversus totalis who presented with fever, cough and respiratory distress. A chest X-ray showed her heart in the right hemithorax with the cardiac apex pointing towards the right. The findings of an electrocardiogram and echocardiography confirmed the location of her heart in the right hemithorax and an abdominal sonogram showed her liver and gall bladder in midline of her abdomen whereas her stomach was located more towards the right side, her spleen was absent.

Conclusions: Situs inversus totalis, although a rare condition, should be sought for when clinical and radiologic findings indicate dextrocardia, especially as it may be an incidental finding. Doctors should encourage routine medical examination for their patients which could help identify this anomaly, thereby preventing wrong diagnosis and possibly death due to delay in management.

Show MeSH
Related in: MedlinePlus