Abstract
Background Congenitally corrected transposition of the great arteries (ccTGA) is a rare anomaly comprising a minimal portion of congenital heart disease cases. Some patients are not identified until adulthood. A minority of these patients maintain normal functional status into the seventh decade and generally only when no other anomalies exist. We describe a case of ccTGA, dextrocardia, and situs inversus in the oldest patient diagnosed with these congenital abnormalities to date. Case presentation An 83 year old female with known dextrocardia presented with dyspnea and was diagnosed with ccTGA, situs inversus, and new onset heart failure. Conclusions The factors that lead to a delayed presentation of systemic right ventricular failure in ccTGA remain ill-defined. Common adult acquired secondary causes of heart failure, such as hypertension and coronary artery disease, likely play a role in patients with congenital heart disease. Aggressive screening and management of these co-existing diseases may improve overall outcomes in adult patients with congenital heart disease.