Dextrocardia with situs inversus

φA medical student is asked to perform a cardiovascular examination on a patient. After 10 minutes of auscultation with no success, the medical student gives up and asks his resident for help. The resident puts up the patient’s anteroposterior chest radiograph (see image) and begins to explain the molecular etiology of this patient’s condition.
(1) Why was the medical student initially overwhelmed??
(2) What is one respiratory complication that this patient is at increased risk of developing as a result of his condition and why??

Situs Invertus

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David
1 year ago

From the X-ray, it can clearly be seen that the heart is located on the right side of the thorax(dextrocardia). That could explain why the said student was initially overwhelmed, he/she wasn’t getting any reading during the auscultation cus he/she was checking the wrong side.

Mahmud Idris
Mahmud Idris
1 year ago

This condition is called dextrocardia in which d heart is facing d right side instead of the left.
It may be an isolated dextrocardia or other forms, the condition can be diagnosed using chest x-ray, CT scan or MRI
The student was overwhelmed because he wasn’t auscultating in the region were d heart is located

The respiratory complication that this patient is at risk is pneumonia and hypoxia(decreased oxygen). The pneumonia can develop as a result of decreased cilia formation within lung tissue, Hence leads to reduced ability of the lungs to clear away microorganism that enter into the lungs.

David
1 year ago

2. Dextrocardia is More often than none accompanied by a condition known as “Cilliary dyskinesia”.
Cilliary – Cilia.
Dys- Non.
Kinesia- movement.
In this condition, the cilia that helps move the mucus becomes immovable. Which is the respiratory complication of Dextrocardia.

Virgin_carez
Virgin_carez
1 year ago

The condition is termed Dextrocardia ( is the situation why the hearth lies at the right hand side of the chest instead of the left hand side of the chest)..
So the student was over whelmed when he is not hearing the auscultation at the left side not knowing it a defect that the heart lies at the right side.
In shot the respiratory condition of this is that the lungs is supersede by the action of the heart making it difficult for the ciliated muscle if the lung to perform there action…

Aminu Umar ahmad
1 year ago

The patient have dextrocardia meaning that the heart due to genetic abnormality is located in the right side of the chest rather than the normal site which is left
The patient has what is termed as kategerner’s syndrome or otherwise called primary ciliary dyskinesia
The syndrome is characterised by the following
Chronic sinusitis
Bronchiectasis
Situs inversus
Dextrocardia
The main respiratory complications that the patient might experience is bronchiectasis
This is so because in the respiratory pathway there are cilia located which are responsible for clearing of mucus along with some particles and from the molecular basis of cilia there are some proteins which helps in the motility of the cilia. So due to the genetic abnormalities of those proteins the cilia is inactive so the clearance of the mucous is impaired which give a way for recurrent respiratory tract infections
So the recurrent respiratory tract infection can leads to bronchiectasis which is among the supparative lung disease

Ajunwa Light Idan
Ajunwa Light Idan
1 year ago

The above is a classical example of dextrocardia, as observed in the radiograph, the apex of the heart is pointed to towards the right pulmonary cavity.
The student was unable to auscultate this abnormally positioned heart due to the fact that normally the auscultation point for the apex of the heart lies at the 4th to 5th left intercoastal space but in this patient the apex of the heart is directed to the right so no apex heartbeat is auscultated.
(B) The condition if isolated will result in transposition of the great vessels. Here the aorta now opens into right ventricle the pulmonary artery into the left so the systemic supply for left ventricle remains deoxygenated but the pulmonary artery keep carrying oxygenated blood to the lungs, hence the lungs on keep reoxygenating oxygenated blood why the body receives deoxygenated blood resulting in systemic hypoxia, cyanosis, due to abnormal pressure differences pulmonary hypoplasia may set in.