Images in Cardiovascular Medicine Double-Chambered Right Ventricle and Situs Inversus With Dextrocardia

We report the case of a 74-year-old woman with ahistory of complex congenital heart disease consist-ing of double-chambered right ventricle (DCRV) and situs inversus with dextrocardia. To our knowledge, this is the first reported case with the combination of these 2 con-genital abnormalities. The patient was transferred to our hospital after experiencing abdominal discomfort, malaise, and cold sweats for 3 days. Initial examination revealed slightly elevated cardiac troponin T (peaked at 0.56 ng/ mL). With her known history of dextrocardia, 12-lead surface electrocardiography (ECG) with both standard precordial leads (Figure 1A) and right-sided precordial leads (Figure 1B) was performed. The standard ECG was notable for inverted P waves in the lateral leads (I and aVL), suggesting rightward atrial electric forces and poor R wave progression. The right-sided precordial lead EC