Keywords
Dextrocardia
Congenital malformation
How to Cite
Abstract
Introduction :
Complete situs inversus is a rare congenital malformation. It is asymptomatic and compatible with normal life. The diagnosis of situs inversus totalis is often made incidentally in adulthood during a paraclinical examination. The aim of this study was to report a case of situs inversus totalis discovered during an electrocardiogram (ECG) performed as part of the work-up for hypertension in a 59-year old patient.
Observation :
A 59-year-old patient, living in a rural area, with known hypertension, consulted our department for his medical follow-up. Physical examination revealed an elevated blood pressure of 191/110mmHg, with a peak shock in the 5th right intercostal space. The electrocardiogram showed signs suggestive of dextrocardia: inversion of the P wave in I, aVL and aVR; dominant S wave in I, and from V1 to V6 with inverted progression of the R wave in precordial leads; low voltage of the QRS axis from V4 to V6; extreme QRS axis, flattened T waves from V4 to V6 and in aVR and inverted T waves in I and aVL leads. Chest X-ray and abdomino-pelvic ultrasound confirmed the diagnosis of Situs Inversus Totalis. Nicardipine 20 mg/12 hours normalized blood pressure. The patient was informed of his anatomical condition and advised on the need to inform the attending physician at every consultation, in order to avoid diagnostic and therapeutic errors.
Conclusion :
This study highlights the value of the electrocardiogram as a simple, non invasive means of diagnosing dextrocardia and other cardiac anomalies in resource limited centers.
References
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