Isolated dextroversion: A case report
We report a case of an asymptomatic elderly woman who was found to have isolated dextroversion on a routine echocardiogram obtained before induction chemotherapy for acute myelogenous leukemia. On examination, the heart sounds appeared distant, with no other abnormalities. The chest x-ray showed mildly elevated right hemidiaphragm, an enlarged silhouette, and left pleural thickening. The cardiac workup included an electrocardiogram, which was abnormal. An echocardiogram was done to assess cardiac function. It showed dextroversion without transpositions of the great vessels or any other cardiac malformation; the ventricles appeared to point to the right. A contrast study confirmed the dextroversion and normal attachment of the great vessels. Dextroversion was an unexpected finding on an echocardiogram done to assess cardiac function before induction chemotherapy. The echocardiogram excluded anterior wall myocardial infarction and provided the correct explanation for an abnormal electrocardiogram.