Utama Harry Wahyudhy, Widyoningroem Anita
Radiology Resident, Department of Radiology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia.
Thoracic Radiologist, Department of Radiology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia.
Radiol Case Rep. 2021 Dec 28;17(3):735-739. doi: 10.1016/j.radcr.2021.12.021. eCollection 2022 Mar.
Situs inversus with a coronary artery defect is an extremely rare congenital anomaly, which is often only incidentally detected during cardiac imaging studies, particularly when the patient is complaining of chest pain. We present a case study of a 37-year-old man who presented with a 3-month history of chest pain. A chest X-ray revealed dextrocardia with stomach gas in the lower right diaphragm. A CT examination showed that the right lung had 2 lobes, and the left lung had 3 lobes. This confirmed that the patient had dextrocardia with situs inversus, where the heart, organs and coronary arteries are inverted to the opposite side of the body. It is also known as a mirroring image, as the arrangement of the anatomy is unaffected. The patient's right coronary artery was prominently inversed to the left side, while the left main coronary artery was inversed to the right side and continued toward the anterior interventricular sulcus, eventually becoming the left anterior descending (LAD) artery. The left circumflex artery was absent in the atrioventricular groove. There was also a plaque in the right-sided LAD with no significant stenosis. The patient received conservative medical therapy and had frequent follow-ups to check for potential complications.
伴有冠状动脉缺损的内脏反位是一种极其罕见的先天性异常，通常仅在心脏影像学检查中偶然发现，尤其是当患者主诉胸痛时。我们报告一例37岁男性病例，该患者有3个月的胸痛病史。胸部X线显示右位心，右下膈肌处有胃内气体。CT检查显示右肺有2个肺叶，左肺有3个肺叶。这证实该患者为右位心伴内脏反位，心脏、器官和冠状动脉均反位至身体的另一侧。它也被称为镜像，因为解剖结构的排列未受影响。患者的右冠状动脉明显反位至左侧，而左主冠状动脉反位至右侧并继续走向前室间沟，最终成为左前降支（LAD）动脉。房室沟处无左旋支动脉。右侧LAD处还有一个斑块，但无明显狭窄。该患者接受了保守药物治疗，并频繁进行随访以检查潜在并发症。
