Anesthetic Challenges in Dextrocardia and Situs Inversus with Ischemic Heart Disease Posted for Total Knee Replacement

A BSTRACT Dextrocardia with situs inversus (SI) is a rare congenital condition in which the heart is located on the right side of the chest (dextrocardia), and all other internal organs are mirrored from their usual positions (situs inversus). Diagnosis relies on physical exams and imaging techniques such as X-ray, computed tomography scan, echocardiography, and magnetic resonance imaging. Our patient was incidentally diagnosed with dextrocardia with SI at the age of 54 during coronary angiography performed for chest pain evaluation, which revealed coexisting ischemic heart disease (IHD). IHD in SI has not been studied in detail. Managing such patients presents a unique set of challenges that arise from both the anatomical anomalies and syndromes associated with SI and the cardiovascular complications of IHD.