Isolated levocarida: Two cases with abdominal situs inversus, thoracic situs solitus, and normal circulation
1983; Elsevier BV; Volume: 106; Issue: 1 Linguagem: Inglês
10.1016/0002-8703(83)90456-8
ISSN1097-6744
AutoresK.A. Chacko, S Krishnaswami, I P Sukumar, George Cherian,
Tópico(s)Coronary Artery Anomalies
ResumoLevocardia is said to be present when the major portion of the heart is in the left chest with its base-apex axis pointing caudally and to the left. When this condition is associated with visceral situs other than solitus, either inversus or ambiguous, it is called isolated levocardia.1-6 The condition is usually associated with complex cardiac defects and cyanosis is the rule,1*3*7s* more so in situs ambiguous which makes up about 80% of the cases.*.6 Even among the smaller group with situs inversus and normal spleen, hearts without defects or with only simple anomalies are rare.2*3**-11 Many reported examples of acyanotic levocardia do have structural defects like large atrial septal defect,‘* atrioventricular valve insufficiency,*s3 ventricular septal defect,‘” bicuspid aortic valve with regurgitation: atria1 septal defect with partial anomalous pulmonary venous drainage,lO and pulmonic stenosis.ll Harris and Rainey,8 in a review of the English literature up to 1965, collected more than 160 cases of isolated levocardia but found only nine having a normal heart. We hereby record two such cases studied recently, one entirely normal and another with mild puhnonic stenosis. Case 1. A 5-year-old male child was admitted for evaluation. Born to nonconsanguineous parents at the thirty-seventh week of gestation by cesarean section, the child’s development was normal. The mother was schizophrenic, and during pregnancy she was taking antidepressant medication, the details of which were not available. The child used to get respiratory infection periodically. A heart murmur was detected when he was 3 years old. Examination revealed a well-developed child in no distress. Pulse was 88/min, regular, and normal in character. Blood pressure was 120/70 mm Hg. Jugular venous pressure was normal. The apical impulse was in the fifth intercostal space on the left midclavicular line. The first heart sound was normal and the second sound was normally split. There was a grade 3 out of 6 ejection systolic murmur along the left sternal border. Hepatic dullness was on the left hypochondrium and gastric tympany was on the right. The spleen was not felt. Examination of other systems was unremarkable. Hematologic and biochemical investigations were all normal. Howell-Jolly bodies were
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