January 1964

Rheumatic Heart Disease and Dextrocardia

Author Affiliations


From the Centre de Cardiologie (Director: Prof P. W. Duchosal), University of Geneva, School of Medicine.

Arch Intern Med. 1964;113(1):19-22. doi:10.1001/archinte.1964.00280070021005

Acquired valvular lesions are rarely associated with dextrocardia and situs inversus. Very few hemodynamic data are available in these observations. We felt that a case of mitral stenosis in which combined cardiac catheterization was performed would be worth reporting. This patient, moreover, had undergone commissurotomy seven years earlier.

Report of a Case  A 38-year-old white woman suffered a first episode of rheumatic fever at the age of five years and another one at 16. Diphtheria and scarlet fever were denied. Complete situs inversus was discovered early. Progressive dyspnea appeared in 1950, after two uneventful pregnancies. In 1956, the auscultation was described as typical of mitral stenosis; the electrocardiogram showed inverted P waves in lead I; venous catheterization revealed increased pressures with a pulmonary wedge of 21 mm Hg. Digital valvotomy was performed in May, 1956: The surgeon observed a tight stenosis (about 1.0 sq cm) which was opened up to

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