Reviewed By Mark A Fogel MD, FACC, FAAP, Associate Professor of Pediatrics and Radiology, Director of… Cardiac MR, The Children's Hospital of Philadelphia, Division of Cardiology, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.more »
Definition
Dextrocardia is a condition in which the heart is located in the right side of the chest instead of the left. It can be present at birth (congenital) or caused by disease or surgery.
Alternative Names
Detroversion; Dextroposition; 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 in 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 do 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:
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 stronger so surgery is possible.
Some syndromes that include dextrocardia may run in families. If you have a family history of heterotaxy, talk to your health care provider before becoming pregnant.
While there are no known ways to prevent dextrocardia, avoiding the use of illegal drugs (especially cocaine) before and during pregnancy may lower the risk of this problem.
Talk to your health care provider if you have diabetes, because it may contribute to your risk of having a child with certain forms of dextrocardia.
References
Kliegman RM, Behrman RE, Jenson HB, Stanton BF, Zitelli BJ, Davis HW. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: WB Saunders; 2007:chap 431
Park MK. Park: Pediatric Cardiology for Practitioners, 5th ed. Philadelphia, PA: Mosby Elsevier; 2008:chap 16.
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