Abstract

Dextrocardia is a rare non-fatal congenital anomaly. Most cases were diagnosed incidentally and throws lot of diagnostic and therapeutic challenges in general and management in particular. We come across 3 different cases with Dextrocardia. First case was asymptomatic young female for regular health check. Second case was middle aged male with Acute MI. Coronary Angiogram revealed lesion in RCA. Managed with Primary PTCA and Stent to RCA. Third case was elderly female with multiple comorbidties came with Positive TMT. Coronary Angiogram revealed TVD. Underwent CABG with 2 grafts. All three cases were treated successfully. We faced lot of Diagnostic to Therapeutic challenges. This includes - ECG & Chest Ray Interpretations, 2D Echo observations, Accessing and engaging coronary ostium, Contrast overload and Recognition of parts of cardiac surface anatomy especially during cardiac surgery. Dextrocardia is not an uncommon congenital cardiac anomaly. Its importance increases whenever it is associated with other cardiac illness in general and ACS in particular. Difficulty exists in both structural and functional assessment of the heart and coronary arteries. Various techniques are used to overcome these problems. Cautious and timely intervention is required. This will not only reduce the time taken for intervention (if required), but also minimizes the complications in a safe and cost-effective manner.

Description