Dextrocardia case study

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Dear Friend, On a beautiful late spring afternoon, this past year, a young woman received the devastating news. She had just gotten back her result on the ANCC exam. It was not what she had hoped for. In fact, it was not even close to the expectations she had considering her past experience and educational background. She had failed. Then she remembered her friends and felt even worse.

A case of complete situs inversus

A case of complete situs inversus

You and your EMT partner respond to a call for a year-old male complaining of chest pain. You re-check the leads and find a lead reversal. The lead ECG has become an exceptional prehospital tool in the detection and treatment of life-threatening arrhythmias and cardiac-associated complaints. Lead misplacement, however, can cause misinterpretation of ST changes, electrical axis, location of bundle branch blocks and location of infarct.

Dextrocardia

Dextrocardia is a congenital cardiac malposition in which the heart is situated on the right side of the body dextroversion with the cardiac apex pointing to the right. Dextrocardia merely refers to the laterality of the heart, it says nothing about the orientation of the patient's other organs. Levocardia is the term used for the heart being positioned on the left as is found in the vast majority of the healthy population. The most prominent abnormality recognized on ECG is the "global inversion" of standard limb lead I, with inversion of the P wave, QRS complex, and T wave, suggestive of either dextrocardia or limb lead misplacement the RA, or right arm, lead was placed on the left and vice versa. Use of the precordial leads allows discrimination of these two entities, specifically by observing the precordial R wave progression.
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