Case 4

Published on 02/03/2015 by admin

Last modified 03/03/2015

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Case 4

A 56-year-old man with no prior cardiac history was referred for SPECT MPI for evaluation of dyspnea.

Exercise parameters: 10:00 Bruce protocol (11.7 METs), peak HR 169 beats/min (102% of maximum age-predicted HR), no symptoms, normal BP response, abnormal ECG response (>1 mm ST depression)

Baseline 12-Lead ECG

The baseline ECG demonstrates an abnormal P-wave axis, premature supraventricular complexes, and right-axis deviation of the QRS complexes. There is abnormal R wave progression in the precordial leads. The constellation of findings is suggestive of dextrocardia.

Raw Planar Images

The images were acquired over 180 degrees from the 45-degree right posterior oblique to 45-degree left anterior oblique orientations. Note that the heart is located in the right side of the chest, consistent with dextrocardia. The liver is located on the left, consistent with situs inversus.