Two Chambered Heart with Situs Ambiguous Rarest Case Report

We present a rare case of two chambered heart (common atrium with common ventricle) in situs ambiguous in a 2-month-old male child. In view of dyspnea, fatigue, and central cyanosis, the patient was referred to us with a provisional diagnosis of congenital cyanotic heart disease. The baby had a body weight of 3.0 kg and an oxygen saturation of 80 % at room air. The auscultatory findings included a single first and second heart sound and soft Grade II/VI ejection systolic murmur. Plain radiograph of the chest in posterior-anterior view revealed the cardiac silhouette on the midline of the thorax with base to apex axis to left suggestive of mesocardia. Trachea bifurcating into morphologically similar bronchi (bronchi are long and more vertical? Right sided), liver is transverse with absent fundic bubble shadow on the left side. Chest radiograph goes in favor of right isomerism. Echocardiogram revealed inferior vena cava (IVC) on left and aorta on right, a common atrium, single ventricle of left ventricular morphology, common atrioventricular valve with moderate regurgitation, IVC opening into right side of common atrium, aorta on left and anterior, pulmonary atresia, left-sided aortic arch with large patent ductus arteriosus. Again, these anomalies are commonly associated with right isomerism. Ultrasonography of the abdomen showed absence of spleen with midline liver and IVC and aorta on the same side of spine favourig right isomerism. The patient was posted for a palliative Blalock–Taussig shunt surgery but died suddenly