Dextrocardia as an uncommon cause of inferior ST-segment elevation
https://orcid.org/0000-0002-7337-0593
Eliomar Garcia-Bello
https://orcid.org/0009-0008-5798-7754
Pablo Zulet
https://orcid.org/0000-0001-7787-7239
Abstract
A 36-year-old woman with surgically repaired transposition of the great vessels was admitted with psychiatric symptoms. The 12-lead ECG showed ST-segment elevation in the inferior leads, a positive P wave in aVR, and an absent R wave progression in the precordial leads. The findings were attributed to atrial repolarization (Ta) waves in the setting of dextrocardia and low atrial rhythm, causing ST-segment elevation in the inferior leads. No cardiac symptoms were present, and additional tests ruled out ischemia. Atrial repolarization waves are typically imperceptible on ECG but can become evident in certain conditions, such as low atrial rhythm. This case represents a rare coexistence of dextrocardia and ST-segment elevation due to an inverted atrial repolarization wavefront in the setting of low atrial rhythm. Recognizing this pattern is essential to prevent misdiagnosis and avoid unnecessary procedures.
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ST-SEGMENT ELEVATION, dextrocardia, CONGENITAL HEART DISEASE, ATRIAL REPOLARIZATION, ECG, Ta
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3. Manne JRR. Atrial Repolarization Waves (Ta) Mimicking Inferior Wall ST Segment Elevation Myocardial Infarction in a Patient with Ectopic Atrial Rhythm. Case Rep Med. 2018 Jan 18;2018:1015730. doi: 10.1155/2018/1015730. PMID: 29559997; PMCID: PMC5822924.
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