ECG and CXR in Kartagener Syndrome

ECG and CXR in Kartagener Syndrome

ECG in Kartagener syndrome showing features of dextrocardia
ECG in Kartagener syndrome showing features of dextrocardia

Negative P wave, QRS complex and T wave in lead I, right lower quadrant QRS axis and regression of QRS amplitude from V1 to V6, as the heart is on the opposite side are the features of mirror image dextrocardia in Kartagener syndrome. An easy way to pick up abnormalities in ECG in dextrocardia is to take a reverse ECG, reversing the limb electrodes from the right to left and reversing the precordial leads from left to right. Kartagener’s syndrome is characterised by dextrocardia with situs inversus, chronic sinusitis and bronchiectasis. They have immotile cilia or dyskinetic cilia and immotile spermatozoa. Infertility in males and lowered fertility in females are noted [1]. Kartagener’s syndrome is one of the syndromes in the constellation of other syndromes in CHD, though other cardiac malformations are uncommon in this syndrome.

X-ray Chest PA view in Kartagener's syndrome
X-ray Chest PA view in Kartagener’s syndrome

X-ray Chest PA view in Kartagener syndrome showing dextrocardia and features of bronchiectasis, more on the left side. Left dome of diaphragm is higher and the fundal gas bubble is seen on the right side, indicating situs inversus. More vertical bronchus is on the left side. There is partial fusion of first and second ribs on the left side, as an incidental abnormality.

Reference

  1. Peters R, de Jonge G. Kartagener’s Syndrome: Situs Inversus, Chronic Sinusitis and Bronchiectasis. J Belg Soc Radiol. 2016 Feb 10;100(1):25.