PMC8039098_01
Electrocardiogram shows normal axis and negative T-waves in leads V1-5 at presentation.
NCI-8-193-g001.jpg
PMC8039098_01_NCI-8-193-g001.jpg
F1
Electrocardiography showed normal axis, normal sinus rhythm with 47 heart bpm, and negative T-waves at V1-5 leads (Fig. 1).
The image of the left deviated heart in two-dimensional echocardiography. The apical 4-chamber window showing the abnormal position of the apex, receding to the left (unusual long-axis parasternal view with an oblique).. LA: Left atrium; LV: Left ventricle; RA: Right atrium; RV: Right ventricle.
NCI-8-193-g002.jpg
PMC8039098_01_NCI-8-193-g002.jpg
F2
Transthoracic echocardiography (TTE) showed an unusual view with the apex subsiding posteriorly in the thorax the apical window was displaced at the posterior (Fig. 2).
Chest X-ray image: Frontal projection showing heart displacement in the left sided (arrow).
NCI-8-193-g003.jpg
PMC8039098_01_NCI-8-193-g003.jpg
F3
A posteroanterior chest radiograph showed loss of the right heart border and on the lateral view a posterior bulging of the heart with the apex (Fig. 3).
Computed tomography angiography imaging and chest X-ray in a patient. (A) The chest computed tomography (CT) image shows the absence of pericardium along with the cardiac chambers (white arrows). Chest CT also reveals deviation of cardiac apex to a more lateral position and shift of heart to the left hemithorax. (B) The chest CT reveals the interposition of the lung between the aortic arch and pulmonary trunk (white arrow).. LA: Left atrium, LV: Left ventricle, RA: Right atrium, RV: Right ventricle, Ao: Aorta, P: Pulmonary trunk
NCI-8-193-g004.jpg
PMC8039098_01_NCI-8-193-g004.jpg
F4
MRI could not be performed due to knee prosthesis, so computed tomography angiography (CT angiography) was performed and revealed that the whole heart was shifted in the left hemithorax with the apex pointing posteriorly and PA (Fig. 4a). Furthermore, chest CT shows interposition of the lung between the aortic arch and pulmonary trunk (Fig. 4b).