In suspected dextrocardia, initial imaging sequence is?

In suspected dextrocardia, initial imaging sequence is?

• A. ECG then CT scan
• B. Chest X-ray then echocardiography
• C. MRI then angiography
• D. Ultrasound of abdomen

Answer: (B)

The initial imaging step in suspected dextrocardia is to obtain a chest radiograph to confirm the heart’s position. A chest X-ray can quickly reveal that the cardiac silhouette is on the right side or show mirror-image anatomy, which signals dextrocardia or situs inversus and guides further evaluation. Following that, echocardiography is performed to define intracardiac anatomy, assess chamber sizes, valve function, and identify any congenital heart defects. This combination—screening with chest X-ray and detailed assessment with echocardiography—provides a rapid, noninvasive way to establish both the presence and the specifics of the unusual cardiac orientation. Other imaging sequences are not as useful as the initial step: cross-sectional imaging like CT or MRI can give detailed anatomy but are not first-line due to cost, availability, and, in the case of CT, radiation; abdominal ultrasound does not inform cardiac position.

The initial imaging step in suspected dextrocardia is to obtain a chest radiograph to confirm the heart’s position. A chest X-ray can quickly reveal that the cardiac silhouette is on the right side or show mirror-image anatomy, which signals dextrocardia or situs inversus and guides further evaluation.

Following that, echocardiography is performed to define intracardiac anatomy, assess chamber sizes, valve function, and identify any congenital heart defects. This combination—screening with chest X-ray and detailed assessment with echocardiography—provides a rapid, noninvasive way to establish both the presence and the specifics of the unusual cardiac orientation.

Other imaging sequences are not as useful as the initial step: cross-sectional imaging like CT or MRI can give detailed anatomy but are not first-line due to cost, availability, and, in the case of CT, radiation; abdominal ultrasound does not inform cardiac position.