Situs Inversus in A 53 Year Old Man: A Case Report

Background: Total or complete visceral situs inversus is the complete inversion of position of the thoracic and abdominal viscera. It may be isolated or associated with malformations, especially cardiac or alimentary. It may be discovered in infancy because of associated anomalies but often remains asymptomatic and discovered by chance in adult life.Method: The case records of the index patient and literature review on the subject were utilized.Result: A 53 year old man was referred to the cardiology clinic from the general outpatient department on account of an abnormal ECG. On examination his apex could not be located on the left and was subsequently located on the right 5th intercostal space mid-clavicular line. Examination of the abdomen revealed an inversion of position of the liver and spleen. Chest X-ray showed the heart in the right hemithorax with the cardiac apex pointing to the right, the aortic arch and gastric air bubble were located on the right as well. Lungs and thoracic cage were normal. Echocardiography showed a mirror image dextrocardia. While electrocardiography revealed inverted P waves in lead 1 with predominantly downward QRS complexes in leads 1, V and V . 5 6 Abdominal scan showed mirror-image anatomy of the abdominal viscera.Conclusion: Situs inversus totalis though a rare condition, should be sought for when clinical and radiologic findings indicate dextrocardia, especially as it may be an incidental finding.Key Words: Dextrocardia; Situs Inversus; Totalis; Nigerian male