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    Human Health Campus
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    Single episode of chest pain post-PTCA, with normal ECG and enzymes

    Teaching Case

    Case presentation:

    • Female.
    • 54 y.o.
    • Smoker, dyslipidemic, asthmatic.
    • Acute coronary syndrome 3 ys. ago with PTCA (LCx).
    • Admitted for single episode of chest pain radiated to neck.
    • Rest ECG and enzymes negative for AMI.
    • Submitted for stress MPS with exercise.

    Teaching points:

    • Dextrocardia is a congenital defect in which the heart is situated on the right side of the chest.
    • There are 2 main types of dextrocardia: isolated dextrocardia and dextrocardia with situs inversus.
    • In patients with dextrocardia, 180-degree imaging should be performed on a SPECT camera from the left anterior oblique to right posterior oblique rather than the usual right anterior oblique to left posterior oblique.
    • The perfusion images highlight the normal difference in length between the septum and lateral wall as seen in the vertical long-axis views, regardless of cardiac position.

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