Dextrocardia with situs inversus totalis (SIT) is a rare congenital anomaly involving complete mirror-image reversal of thoracic and abdominal organs, which may complicate diagnostic evaluation and management despite often being benign. We report a 45-year-old Ethiopian woman with type 2 diabetes mellitus and hypertension who presented with dry cough, right-sided pleuritic chest pain, dyspnea, and low-grade fever. Examination revealed respiratory distress and a right-sided cardiac apex, while laboratory workup demonstrated anemia, impaired renal function, and proteinuria. Imaging confirmed SIT with right lower lung consolidation and incidental cholelithiasis, and electrocardiogram (ECG) showed extreme right-axis deviation with absent R-wave progression; echocardiography revealed normal intracardiac anatomy and preserved function. Although SIT is commonly discovered incidentally, reversed anatomy can create diagnostic challenges and requires careful clinical correlation, particularly in settings with limited imaging availability. This case highlights the importance of recognizing SIT to prevent misinterpretation, guide safe management, and contribute to the limited regional epidemiological data.
Mesele et al. (Sun,) studied this question.