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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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