Situs inversus and levo-transposition of the great arteries with cardiac pacemaker

Case contributed by Sajoscha A. Sorrentino
Diagnosis certain

Presentation

Known case of complex congenital heart disease with prior cardiac surgery.

Patient Data

Age: Adult
Gender: Male

There is situs inversus with levocardia. 

Cardiac pacemaker with unusual placement of the electrode tips is demonstrated.

Case Discussion

While the heart shadow may not give it away at once, note the unusual position of the pacemaker electrodes.

Not only that the patient has situs inversus, this is also a diagnosed case of levo-transposition of the great arteries with an ostium secundum atrial septal defect, large membranous ventricular septal defect and pulmonary (valve) stenosis. He previously underwent Blalock-Taussig shunt procedure, closure of the septal defects and correction of the pulmonary stenosis.

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