What anticipatory management should we do for a patient with an incidental finding of dextrocardia?
I don't do much congenital heart disease, so this was a nice opportunity for me to review this cardiac abnormality. One recalled learning point for me is that situs inversus with a R-sided heart is usually structurally normal but situs inversus with a L-sided heart is associated with other congenital abnormalities. And, for the former, we should change limb and precordial leads to get an ECG, but in the case of sinus solitus with a R-sided heart, only the precordial leads need to be modified. Patients are usually diagnosed and treated by the time I see them, but the attached article goes on to describe some of the specific structural and electrical abnormalities we can see in right and left isomerism, so enjoy!
Perloff JK. The cardiac malpositions. The American Journal of Cardiology. 2011;108(9):1352-1361.
Willy K, Dechering DG, Reinke F, Bögeholz N, Frommeyer G, Eckardt L. The ECG in sarcoidosis – a marker of cardiac involvement? Current evidence and clinical implications. Journal of Cardiology. Published online September 2020.
