Fig.1. Transthoracic chocardiogram of a 33-year-old female referred to rule out mitral valve prolapse. Panels A, B, & C shows that the heart is shifted to the left with slight posterior rotation and the aorta arises normally from the left ventricle. Panel C shows normal atrioventricular concordance. In panel D the aorta and pulmonary arteries are malaligned with side to side orientation. No structural intracardiac abnormality was noted and hemodynamic evaluation was normal.

Fig. 2. CXR shows the cardiac silhouette completely to the left 
of the sternum.

Fig. 3. ECG shows shift in the transitional zone to the left (seeV5 - blue circle).

Abbreviations: A=anterior P=posterior I=inferior B=base RA=right atrium Rv=right ventricle Lv=left ventricle Ao= aorta

 From the Echocardigraphy Laboratory, Cardiology & Cardiovascular Surgery Department, Hamad Medical Corporation, Doha, Qatar