Rare Presentation of Congenitally Corrected Transposition of Great Arteries

Congenitally corrected transposition of great arteries is a rare congenital heart defect with varied presentation. It can be fatal in infancy, to heart failure or complete heart block in adults. Clinical presentation depends on associated defects. Coronary artery anomalies are more frequent in CCTGA. We present a case of 43-year-old man with dextrocardia CCTGA asymptomatic all life present to us with non-ST segment elevation MI. He had no additional defect except systemic ventricular defect with moderate regurgitation of tricuspid valve. He was managed with early invasive therapy with coronary angiogram followed by percutaneous coronary intervention. Learning Objective: Diagnosis of acute coronary syndrome in adult congenital heart disease needs expertise in both coronary and congenital heart disease fields. CCTGA is very rare congenital heart disease with varied presentation depending upon associated defects. Coronary intervention in CCTGA with dextrocardia requires technical and fluoroscopic anatomical orientation of heart. Radial access with coronary diagnostic and interventional procedures is feasible and drug eluting coronary stents can be used to manage occlusive atherosclerotic lesions.