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          Human Health Campus
          Human Health Campus
          Human Health Campus

          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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