An Elderly Woman with Exertional Dyspnoea and T-Wave Inversions on Electrocardiography

Abstract

We present a case of a 75-year-old woman with cardiac dextroposition who presented for preoperative cardiac evaluation because of exertional dyspnoea. On examination, heart sounds were best appreciated on the right, and bowel sounds were heard over the left hemithorax. Electrocardiography showed widespread T-wave inversions. No coronary artery ischemia was found. A large congenital diaphragmatic hernia with displacement of the heart to the right was found on chest radiography and confirmed on computed tomography. Surgery was subsequently uneventful. In conclusion, thorough pulmonary auscultation to detect bowel sounds in the thorax increases clinical suspicion of cardiac dextroposition.