A Twist of Fate: Situs Inversus Totalis with Dextrocardia

Ostensible signs of a technical error proved to be indications of a congenital anomaly. An extra step in the cardiac examination could have identified the difference. This was evident when an obese 68-year-old African American man presented to our emergency department at Trinitas Regional Medical Center with acute left-sided weakness and left facial droop that started 1 hour before presentation. The patient denied headaches, dizziness, or chest pain. Although the patient had no cardiac history, he had been diagnosed with noninsulin-dependent diabetes mellitus 9 years earlier. His family history was not significant. He was a 30 pack-year smoker, but he did not use alcohol or recreational drugs. Here, Saad et al present their assessment, diagnosis, and management of the patient.