7th Annual Scientific Meeting in Chest Radiology

Jakarta, 11-12 August 2018

PENTALOGY OF FALLOT WITH

DEXTROVERSION

A Mustain1, L Attamimi2, S Asriyani2, N Latief2, R Rauf2

Radiology Resident, Hasanuddin University1
Department of Radiology, Hasanuddin University2
 INTRODUCTION
• Pentalogy of Fallot is a rare form of cyanotic
congenital heart disease, characterized by an
association of ASD with Tetralogy of Fallot.
• ASD is present in one third of patients with
Tetralogy of Fallot.
• Dextroversion (dextrocardia with situs solitus)
is a rare anomaly characterized by right-
sided rotation of the heart with normal
position of cardiac chamber
 OBJECTIVE
To present a case of 20-year-old female with
multiple rare congenital heart disease which
have Pentalogy of Fallot with dextroversion
using chest x-rays, echocardiography and
MSCT scan cardiac
 METHOD
Chest X- rays PA view, echocardiography
and MSCT scan cardiac with contrast are
need to diagnostic of Pentalogy of Fallot
with dextroversion
 RESULT
A 20-year-old female presented with
dyspneu, palpitation, fatigue especially after
exercise, no chest pain, no nausea and
vomiting, syncope since several last month,
history of peripheral cyanosis since about
10 year old, no family history of congenital
heart defects. On physical examination,
pansistolic murmur (+)
 RESULT
• Chest X-ray (PA View) revealed dextrocardia
• Echocardiography showed situs solitus,
dextrocardia with VSD perimembran, ASD
secundum and pulmonal stenosis, differential
diagnosis dextrocardia with Pentalogy of Fallot
• MSCT scan cardiac with contrast showed
cardiomegaly (RVE, RVH, RAE) with VSD, ASD
and stenosis of main pulmonary artery
correspond with Pentalogy of Fallot, left sided
superior vena cava that flows into right atrium
CHEST X-RAYS

Fig 1. Chest X-Ray showed that the

cardiac apex was located in the right
hemithorax with normal pulmonary
vascularization
 MSCT SCAN CARDIAC WITH CONTRAST
Fig.2. (a) axial and
(b) coronal CT
images show right-
sided rotation of the
heart with normal
position of cardiac
chamber and
2a 2b ASD (arrow)

Ao
Fig 3. (a) axial CT
VSD
Ao Override images show VSD
(arrow) and (b)
RV LV
coronal view show
aortic override with
3b VSD
 MSCT SCAN CARDIAC WITH CONTRAST

Ao
MPA

RV
LV

Fig 4. Coronal CT image show Fig 5. Coronal CT image show

supravalvular main pulmonary left sided superior vena cava
artery stenosis (d=1,5 cm) that flows into right atrium
 ECHOCARDIOGRAPHY

Fig 6 : (a) Echocardiography subcostal

view revealed ASD. (b)
Echocardiography apical four chamber
dextra view revealed VSD. (c)
Echocardiography parasternal long
axis dextra view revealed aortic
override with VSD
a

b c
 CONCLUSION
Pentalogy of Fallot with dextroversion is a
rare of cyanotic congenital heart disease.
MSCT scan cardiac and echocardiography
are examination procedure to evaluate heart
defect and position of heart chamber