PMC7455845_01
Admission standard 12-lead electrocardiogram (ECG) demonstrating inferior ST elevation, atrial fibrillation with rapid ventricular response, and features associated with dextrocardia (loss of praecordial R wave progression, dominant praecordial S wave).
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Her admission ECG demonstrated inferior ST-segment elevation (Figure 1) in the setting of AF with rapid ventricular response. She spontaneously reverted to sinus rhythm at the time of angiography, with resolution of chest discomfort and ECG changes (Supplementary Figure 1).
Chest X-ray demonstrating multifocal pneumonia, right-sided aortic arch, cardiac silhouette, and gastric bubble.
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Chest X-ray demonstrated multifocal pneumonia and a rightward-facing cardiac apex, a right-sided aortic arch, and a right-sided gastric bubble consistent with situs inversus dextrocardia (Figure 2).
(a) Coronary angiography demonstrating RCA arising from left coronary cusp with an eccentric mid-RCA stenosis (depicted by white arrow). (b) Left ventriculography demonstrating apical ballooning in keeping with TTC.
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Coronary angiography demonstrated an eccentric mid-RCA stenosis (Figure 3(a)) with mild bystander disease. Left ventriculography demonstrated symmetrical apical ballooning with basal sparing consistent with an apical-variant TTC (Figure 3(b)).