Chest
Volume 81, Issue 3, March 1982, Pages 380-381
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Selected Reports
Coronary Artery Bypass Surgery in a Patient with Situs Inversus

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Coronary artery disease occurs in patients with dextrocardia and situs inversus totalis with an incidence and clinical presentation similar to that in the general population. Such a patient with unstable angina pectoris and subsequent coronary artery bypass surgery is described.

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Case Report

A 58-year-old woman with known situs inversus totalis and adult onset diabetes mellitus had exertional- and anxietyrelated substernal and right anterior chest pain with radiation to the right arm in March 1980. Despite therapy with propranolol and nitrates, she required hospitalization on two occasions for severe and prolonged episodes of chest pain. There were no ECG changes of injury or infarction, and serial cardiac enzymes were normal. She was referred to the Medical University Hospital in

Discussion

Dextrocardia associated with situs inversus totalis is rare and infrequently associated with other congenital heart lesions.3 The incidence of acquired atherosclerotic coronary artery disease in these patients has not been established, but might be expected to be similar to that of the general population.4,5 There have been scattered case reports of myocardial infarction in this patient population.4, 5, 6, 7, 8, 9 Their clinical presentation and subsequent course seem not to differ from those

Acknowledgments

We wish to express our appreciation to John D. Thomas, Jr., M.D., of Loris, S.C., for referring this patient, and to Mrs. Deloris Lindberg for typing the manuscript.

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