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Situs inversus is featured by the switching of the organs to the opposite side of the body. When associated with dextrocardia, it is known as situs inversus totalis. This disease is a uncommon congenital anomaly and can lead to a diagnostic misperception for surgeons because of infrequent location of symptoms resulting in late diagnosis of known pathologies and operative complications because of changed anatomy. Varicose veins of leg, although being commonly reported, to be diagnosed specially in elderly can be notorious if associated with its complications such as ulcers, bleeding, and so on, and when associated with underlying medical illness. We report a rare case where these conditions coexisted. A 62-year-old woman presented with swelling in bilateral lower limbs with pain on walking with hypertension, type-2diabetes mellitus, and situs inversus totalis electively posted for left-sided Trendelenburg’s operation with bilateral superficial ligation of perforators, which we managed successfully under sole epidural anesthesia.

Ventricular septal defect is an acyanotic congenital heart disease, characterized by a left-to-right shunt. The incidence varies between two and six per 1000 live births. It is found in 30% to 60% of all the newborns with congenital heart disease, thus making it one of the most common congenital heart diseases. It can lead to significant hemodynamic changes and patient morbidity and mortality perioperatively, thus posing a challenge to the anesthesiologists. Here, we report the perioperative management of an adult patient with ventricular septal defect and pulmonary stenosis, posted for cholecystectomy, which was successfully managed with general anesthesia and thoracic epidural analgesia.

Cardiac diseases in pregnancy pose a multitude of challenges to both anesthesiologists and obstetricians. Peripartum cardiomyopathy is one of the rare causes of dilated cardiomyopathy in parturients with a great diagnostic difficulty. High degree of suspicion along with good clinical experience is needed for its diagnosis. Unfortunately, mortality from this ranges from 35% to 50%. We report a case of 21-year-old female parturient presenting at 37 weeks of gestation for emergency cesarean delivery with undiagnosed peripartum cardiomyopathy. She developed cardiac arrest soon after giving spinal anesthesia. She was successfully resuscitated and shifted to ICU for further management. Bedside echocardiography was conducted, which showed dilated cardiomyopathy with an ejection fraction of 32%.