An ST-Elevation Myocardial Infarction In Situs Inversus Totalis (DEXTROCARDIA)

A 63-year-old woman with medical history significant for peripheral artery disease, hypertension, hyperlipidema and a 20 pack-year smoking history presented to the emergency department after waking from sleep at 3 am with severe indigestion, nausea, and emesis. On arrival the patient was mildly hypotensive to 102/61  mm Hg with a heart rate of 70 beats/min, and saturating 94% on room air. She had had a dobutamine stress echocardiogram 1 month prior, which was “unremarkable.” The patient added, during electrocardiogram (ECG) lead placement, that her “heart is on the right side” and the ECG was obtained with right-sided precordial leads and standard limb leads (Figure 1).
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Visual Diagnosis in Emergency Medicine Source Type: research