Acute myocardial infarction in dextrocardia - A diagnostic and therapeutic challenge. Can dextrocardia be a risk factor?

Acute myocardial infarction in dextrocardia may present several challenges either in electrocardiographic diagnosis or coronary intervention or both, due to abnormal location of the heart, mirror images o the aorta and its branches, and abnormal coronary origin and orientation. Also, dextrocardia as a risk factor for coronary artery disease is less well established. We report the case of a young patient with dextrocardia and situs inversus without any risk factor who presented with acute extensive anterior wall myocardial infarction diagnosed after lead reversal and who successfully underwent coronary intervention using "double inversion technique". <Learning objective: Dextrocardia imposes a big challenge in diagnosing acute myocardial infarction on electrocardiography (ECG). Both limb and precordial leads should be reversed to reveal all ECG changes. Also because of the unfamiliar anatomy of coronaries and great vessels, double inversion technique is useful during the intervention. It is not well-established whether dextrocardia can be a risk factor for myocardial infarction.>.