Isolated Dextrocardia with Situs Solitus – Dextroversion in a Ugandan Baby: A Case Report

BACKGROUND: Dextrocardia is a rare congenital abnormality in the general population, with an estimated incidence of 1 in 12,000 live births. Isolated dextrocardia, the condition of right-sided heart with situs solitus is most commonly referred to as dextroversion. CASE PRESENTATION: A 2-month-old Ugandan baby boy discovered to have isolated dextrocardia with situs solitus presented with fever, cough, and difficulty in breathing. Physical examination revealed moderate respiratory distress, bilateral basal fine crepitations, tachycardia with regular pulse, and heart sounds best heard on the right hemithorax, but no murmurs. Chest X-ray confirmed right-sided cardiac shadow with cardiac apex pointing to right. Echocardiography showed D-loop ventricular morphology with right cardiac axis and ventricular apex to right, plus tiny patent ductus arteriosus. Abdominal ultrasound showed normal situs solitus; however, the left kidney was noted in pelvic space. CONCLUSION: Isolated dextrocardia with situs solitus (dextroversion) is a rare scenario. This case exhibits a learning point in the significance of routine medical examination of patients to identify anomalies and upon suspicion a thorough evaluation to prevent wrong diagnosis or poor prognosis due to delayed management.