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(Circulation. 1999;100:209-210.)
© 1999 American Heart Association, Inc.

Images in Cardiovascular Medicine

Is This Right? (... or Is It Left?)

Peter G. Danias, MD, PhD; Warren J. Manning, MD

From the Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of the Department of Medicine, Cardiovascular Division (P.G.D., W.J.M.), and the Department of Radiology (W.J.M.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass.

Correspondence to Warren J. Manning, MD, Cardiovascular Division, Beth Israel Hospital, 330 Brookline Ave, Boston, MA 02215.

	Introduction

Top Introduction

 
An asymptomatic 57-year-old woman presented with dextrocardia and situs inversus.

The surface ECG (Figure, panel A) reveals a rightward QRS axis. Poor R-wave progression is present in the standard precordial leads, whereas the right chest leads (rV₁ through rV₆), conversely, demonstrate progression of the R wave. The repolarization abnormality seen in leads rV₄ through rV₆ is secondary to left ventricular hypertrophy related to long-standing systemic hypertension.

View larger version (142K): [in this window] [in a new window]   Figure 1.

The posteroanterior chest radiograph (B) is a mirror image of the normal radiograph, with the heart located at the right hemithorax, the ascending aorta (arrows) and aortic knuckle forming the left heart border, and the left hemidiaphragm positioned higher than the right hemidiaphragm. The letters L and R indicate the patient's left and right side, respectively.

The coronal MRI (C) of the chest and upper abdomen demonstrates the relationship of the thoracic and abdominal organs. AAo indicates ascending aorta; LV, left ventricle; PA, pulmonary artery; and RA, right atrium.

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Danias, P. G. Articles by Manning, W. J. Search for Related Content PubMed PubMed Citation Articles by Danias, P. G. Articles by Manning, W. J. Related Collections Other hypertension Hypertrophy