CardioNerds: A Hidden Heart Defect Revealed in Adulthood

In the latest episode of CardioNerds Case Report series, the team explores a remarkable case from NewYork‑Presbyterian Queens involving a 53‑year‑old woman who, after presenting with chest pain, was found to have dextrocardia on chest X‑ray. Further evaluation via echocardiogram raised suspicion that her systemic ventricle was actually the morphologic right ventricle—a finding confirmed by coronary CT angiography as congenitally corrected transposition of the great arteries (CCTGA). Despite normal troponin levels and minimal coronary disease, therapeutic heparin was initiated before imaging clarified her congenital anomaly. Her chest pain resolved spontaneously, and she opted for follow‑up care with a congenital specialist back in her home country of Guyana. Expert commentary from Dr. Su Yuan highlights the embryologic basis of CCTGA—ventricular looping with atrioventricular and ventriculoarterial discordance—alongside associations like ventricular septal defects, pulmonic stenosis, tricuspid abnormalities, and dextrocardia. The discussion emphasizes how this rare condition often remains clinically silent until adulthood, when systemic right ventricular failure, tricuspid regurgitation, or arrhythmias emerge.