Definition

Dextrocardia is a condition in which the heart is pointed toward the right side of the chest instead of normally pointing to the left. It is present at birth (congenital).

Alternative Names

Detroversion; Dextrorotation

Causes, incidence, and risk factors

During the early weeks of pregnancy, the baby's heart develops. Sometimes, for reasons that are unclear, the heart develops and turns so that it points to the right side of the chest instead of the left side.

There are several types of dextrocardia. Most involve other defects of the heart and abdomen area.

The simplest type of dextrocardia is one in which the heart is a mirror image of the normal heart, and no other problems exist. This condition is rare. Usually in this case, the organs of the abdomen and the lungs will also be arranged in a mirror image of their normal position. For example, the liver will be on the left side instead of the right.

Some people with mirror-image dextrocardia have a problem with the fine hairs (cilia) that filter the air going into their nose and air passages. This condition is called Kartagener syndrome.

In the more common types of dextrocardia, heart defects are present in addition to the abnormal location of the heart. The most common heart defects seen with dextrocardia include:

The abdominal and chest organs in babies with dextrocardia may be abnormal and may not work correctly. A very serious syndrome that appears with dextrocardia is called heterotaxy. Heterotaxy means the organs (atria of the heart and abdominal organs) are not in their usual places.

In heterotaxy, the spleen may be completely missing. Because the spleen is an extremely important part of the immune system, babies born without a spleen are in danger of severe bacterial infections and death. In another form of heterotaxy several small spleens exist, but may not work correctly.

Heterotaxy may also include:

Abnormal gallbladder system
Problems with the lungs
Problems with the structure of the intestines
Severe heart defects

Possible risk factors for dextrocardia include:

Family history of the condition
Mother with diabetes (may play a role in some forms of dextrocardia)

Symptoms

There are no symptoms of dextrocardia if the heart is normal.

Conditions that may include dextrocardia may cause the following symptoms:

Bluish skin
Difficulty breathing
Failure to grow and gain weight
Fatigue
Jaundice (yellow skin and eyes)
Pale skin (pallor)
Repeated sinus or lung infections

Signs and tests

There are no signs of dextrocardia if the heart is normal.

Conditions that can include dextrocardia may cause the following signs:

Abnormal arrangement and structure of the organs in the abdomen
Enlarged heart
Problems with the structure of the chest and lungs, seen on x-rays
Rapid breathing or problems breathing
Rapid pulse

Tests to diagnose dextrocardia include:

Computed tomography (CT) scans
Magnetic resonance imaging (MRI) of the heart
Ultrasound of the heart (echocardiogram)
X-rays

Treatment

A complete mirror image dextrocardia with no heart defects requires no treatment. It is important, however, to let the child's health care provider know the heart is on the right side of the chest. This information can be important in some exams and tests.

Treatment for conditions that include dextrocardia depends on whether the infant has other heart or physical problems in addition to dextrocardia.

If heart defects are present with dextrocardia, the baby will most likely need surgery. Critically ill babies may need treatment with medication before surgery. These medications help the baby grow larger so surgery is less difficult to perform.

Medications include:

"Water pills" (diuretics)
Medications that help the heart muscle pump more forcefully (inotropic agents)
Medications that lower blood pressure and ease the workload on the heart (ACE inhibitors)

The baby might also need surgery to correct problems in the organs of the abdomen.

Children with Kartagener syndrome will need repeated treatment with antibiotics for sinus infections.

Children with a missing or abnormal spleen need long-term antibiotics.

All children with heart defects should get antibiotics before surgeries or dental treatments.

Resources

Top Categories

Product

Company