The patient went to the ER for chest pain that would not subside. She knew she had the condition but she stunned the x-ray techs and the rest of the people at the ED with the film.I hope the next question someone asked after suspecting dextrocardia was: which side are the guts on.
For curiosity's sake (if you're inclined): age range, why coming to the doctor (or ER), and why CT when there is a non-irradiating study that could have given the answer?
haah I read this and I thought "he must be talking about the early episodes of Scrubs where the x-ray is backwards in the beginning of every episode" but its still cool none-the-less though.But the patient really have DextroCardia!! Her heart was on the right side of the chest, confirmed by CT!!!
Will probably never see it again.
I am in my fm rotation and the patient said she has situs inversus so I am assuming she is totally backwards. I only saw the cxr but it would have been cool to see the rest of her.Come on man, you're holding out Where were the guts? Obviously you know a lot more about the case than me, but that question, depending on the rest of the history could be critical...Pleeeeaze
Indeed (and try echoing a dextrocardia, single something ventricle, Fontan...loads 'o fun). That's what interesting about the case as presented. Definitely not the expected milieu to just bump into it. So the DDx for her (presumably an adult) presenting complaint becomes interesting. If she has situs solitus there is a 90% chance she has congenital heart disease of some type. If she has situs inversus (without PCD [Kartagener's]) there is still a 10% chance of some type of CHD. Not all of these would be cyanotic or associated with pulmonary overcirculation (in this patient's case clearly not the former and likely not the latter) but some with some definite ties to the C/C if present in this patient.Do a Pediatric Cardiac ICU rotation, you will see it atleast once a week