Srikant Sanjanaa, Dave Darshit, Dave Dhara
Department of Medicine, Makerere University College of Health Sciences, Kampala City, Uganda.
Department of Paediatrics, Uganda Martyrs Hospital Lubaga, Kampala City, Uganda.
Int Med Case Rep J. 2021 Nov 23;14:797-800. doi: 10.2147/IMCRJ.S340185. eCollection 2021.
Dextrocardia is a rare congenital abnormality in the general population, with an estimated incidence of 1 in 12,000 live births. Isolated dextrocardia, the condition of right-sided heart with situs solitus is most commonly referred to as dextroversion.
A 2-month-old Ugandan baby boy discovered to have isolated dextrocardia with situs solitus presented with fever, cough, and difficulty in breathing. Physical examination revealed moderate respiratory distress, bilateral basal fine crepitations, tachycardia with regular pulse, and heart sounds best heard on the right hemithorax, but no murmurs. Chest X-ray confirmed right-sided cardiac shadow with cardiac apex pointing to right. Echocardiography showed D-loop ventricular morphology with right cardiac axis and ventricular apex to right, plus tiny patent ductus arteriosus. Abdominal ultrasound showed normal situs solitus; however, the left kidney was noted in pelvic space.
Isolated dextrocardia with situs solitus (dextroversion) is a rare scenario. This case exhibits a learning point in the significance of routine medical examination of patients to identify anomalies and upon suspicion a thorough evaluation to prevent wrong diagnosis or poor prognosis due to delayed management.
右位心在普通人群中是一种罕见的先天性异常,估计在每12000例活产婴儿中的发病率为1例。孤立性右位心,即心脏位于右侧且内脏位置正常的情况,最常被称为右心转位。
一名2个月大的乌干达男婴被发现患有孤立性右位心且内脏位置正常,出现发热、咳嗽和呼吸困难。体格检查发现中度呼吸窘迫、双侧肺底细湿啰音、心率加快且脉搏规则,心音在右半胸最清晰,但未闻及杂音。胸部X线证实心脏阴影在右侧,心尖指向右侧。超声心动图显示D袢心室形态,心脏轴向右,心室尖向右,伴有微小动脉导管未闭。腹部超声显示内脏位置正常;然而,左肾位于盆腔。
孤立性右位心且内脏位置正常(右心转位)是一种罕见情况。该病例显示了对患者进行常规医学检查以识别异常的重要性,以及在怀疑时有进行全面评估以防止因管理延迟导致误诊或预后不良的学习要点。