Skip to main content
Springer Nature Link
Log in

Dextrocardia

  • Chapter
  • First Online:
Clinical and Surgical Aspects of Congenital Heart Diseases

  • 898 Accesses

Abstract

Dextrocardia is the first cardiac malposition that was described in the early seventeenth century. It can be explained as a right-sided heart with a base apex axis pointed toward the right side. It occurs very rarely and has 1 in 12,000 incidences. It occurs during development due to a defect in cardiac looping or laterality determination. Even though its cause has not been identified some association have been made with a defect in dynein or ciliary motility.

Patient suffering from dextrocardia can either be asymptomatic or present with a variety of symptoms, most of which can be attributed to the associated anomaly it presents with. In order to make a correct and accurate diagnosis, patients must undergo a thorough physical examination, imaging like X-ray, CT abdomen, ECG, echocardiogram, and cardiac catheterization. Interventions in these patients are comparatively difficult and require a different approach. Treatment in patients of dextrocardia majorly includes managing the underlying problems and anomalies. Special consideration must be given to associated cardiac anomalies before doing any cardiac surgery in such patients. Supportive treatment and counseling of patients and their attendants can be helpful in managing such patients in the long run.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Perloff JK. The cardiac malpositions. Am J Cardiol. 2011;108(9):1352–61.

    Article  Google Scholar 

  2. Mendelson M. Dextrocardia. In: ECG in emergency medicine and acute care. Philadelphia, PA: Elsevier; 2005. p. 227–9.

    Book  Google Scholar 

  3. Grey DP, Cooley DA. Dextrocardia with situs inversus totalis: Cardiovascular surgery in three patients with concomitant coronary artery disease. Cardiovasc Dis. 1981;8(4):527–30.

    Google Scholar 

  4. Lev M, Liberthson RR, Eckner FA, Arcilla RA. Pathologic anatomy of dextrocardia and its clinical implications. Circulation. 1968;37(6):979–99.

    Article  CAS  Google Scholar 

  5. Evans WN, Acherman RJ, Collazos JC, Castillo WJ, Rollins RC, Kip KT, et al. Dextrocardia: practical clinical points and comments on terminology. Pediatr Cardiol. 2010;31(1):1–6.

    Article  Google Scholar 

  6. Rao PS. Dextrocardia: systematic approach to differential diagnosis. Am Heart J. 1981;102(3 Pt 1):389–403.

    Article  CAS  Google Scholar 

  7. Rogel S, Schwartz A, Rakower J. The differentiation of dextroversion from dextroposition of the heart and their relation to pulmonary abnormalities. Dis Chest. 1963;44(2):186–92.

    Article  CAS  Google Scholar 

  8. Bohun CM, Potts JE, Casey BM, Sandor GGS. A population-based study of cardiac malformations and outcomes associated with dextrocardia. Am J Cardiol. 2007;100(2):305–9.

    Article  Google Scholar 

  9. Kennedy MP, Omran H, Leigh MW, Dell S, Morgan L, Molina PL, et al. Congenital heart disease and other heterotaxic defects in a large cohort of patients with primary ciliary dyskinesia. Circulation. 2007;115(22):2814–21.

    Article  Google Scholar 

  10. Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation. 1971;43(3):323–32.

    Article  CAS  Google Scholar 

  11. Samánek M, Slavík Z, Zborilová B, Hrobonová V, Vorísková M, Skovránek J. Prevalence, treatment, and outcome of heart disease in live-born children: a prospective analysis of 91,823 live-born children. Pediatr Cardiol. 1989;10(4):205–11.

    Article  Google Scholar 

  12. Hoffman JI. Incidence of congenital heart disease: I. Postnatal incidence. Pediatr Cardiol. 1995;16(3):103–13.

    Article  CAS  Google Scholar 

  13. Gupta S, Handa KK, Kasliwal RR, Bajpai P. A case of Kartagener’s syndrome: Importance of early diagnosis and treatment. Indian J Hum Genet. 2012;18(2):263–7.

    Article  Google Scholar 

  14. Hanson JS, Tabakin BS. Primary and secondary dextrocardia. Their differentiation and the role of cineangiocardiography in diagnosing associated congenital cardiac defects. Am J Cardiol. 1961;8(2):275–81.

    Article  CAS  Google Scholar 

  15. Wolla CD, Hlavacek AM, Schoepf UJ, Bucher AM, Chowdhury S. Cardiovascular manifestations of heterotaxy and related situs abnormalities assessed with CT angiography. J Cardiovasc Comput Tomogr. 2013;7(6):408–16.

    Article  Google Scholar 

  16. Jacobs JP, Anderson RH, Weinberg PM, Walters HL 3rd, Tchervenkov CI, Del Duca D, et al. The nomenclature, definition and classification of cardiac structures in the setting of heterotaxy. Cardiol Young. 2007;17 Suppl 2(S2):1–28.

    Google Scholar 

  17. Lints TJ, Parsons LM, Hartley L, et al. Nkx-2.5: a novel murine homeobox gene expressed in early heart progenitor cells and their myogenic descendants. Development. 1993;119:419–31.

    Article  CAS  Google Scholar 

  18. de la Cruz MV, Sanchez-Gómez C, Cayre R. The developmental components of ventricles: their significance in congenital malformations. Cardiol Young. 1991;1:123–8.

    Article  Google Scholar 

  19. Black BL, Olson EN. Control of cardiac development by the MEF2 family of transcription factors. In: Harvey RP, Rosenthal N, editors. Heart development. London: Academic Press; 1999. p. 131–42.

    Chapter  Google Scholar 

  20. Knauth A, McCarthy KP, Webb S, et al. Interatrial communication through the mouth of the coronary sinus defect. Cardiol Young. 2002;12:364–72.

    Article  Google Scholar 

  21. Webb S, Kanani M, Anderson RH, et al. Development of the human pulmonary vein and its incorporation in the morphologically left atrium. Cardiol Young. 2001;11:632–42.

    Article  CAS  Google Scholar 

  22. Queiroz RM, Filho FB. Kartagener’s syndrome. Pan Afr Med J. 2018;29(160):160.

    Google Scholar 

  23. Arunabha DC, Sumit RT, Sourin B, Sabyasachi C, Subhasis M. Kartagener’s syndrome: a classical case. Ethiop J Health Sci. 2014;24(4):363–8.

    Article  CAS  Google Scholar 

  24. Dilorenzo M, Weinstein S, Shenoy R. Tetralogy of fallot with dextrocardia and situs inversus in a 7-year-old boy. Tex Heart Inst J. 2013;40(4):481–3.

    Google Scholar 

  25. Ortiz RO, Ali MJ, Lopez FA. CLINICAL CASE OF THE MONTH: a review of situs inversus and dextrocardia. J La State Med Soc. 2015;167(2):102–4.

    Google Scholar 

  26. Rubbo B, Lucas JS. Clinical care for primary ciliary dyskinesia: current challenges and future directions. Eur Respir Rev. 2017;26(145):170023.

    Article  Google Scholar 

  27. Xie L, Zhao J, Shen J. Clinical diagnostic approach to congenital agenesis of right lung with dextrocardia: a case report with review of literature: lung agenesis. Clin Respir J. 2016;10(6):805–8.

    Article  Google Scholar 

  28. Badui E, Lepe L, Solorio S, Sánchez H, Enciso R, García P. Heart block in dextrocardia with situs inversus. A case report. Angiology. 1995;46(6):537–40.

    Article  CAS  Google Scholar 

  29. Fraser FC, Teebi AS, Walsh S, Pinsky L. Poland sequence with dextrocardia: which comes first? Am J Med Genet. 1997;73(2):194–6.

    Article  CAS  Google Scholar 

  30. Fox CJ 3rd, Keflemariam Y, Cornett EM, Urman RD, Rapoport Y, Shah B, et al. Structural heart issues in dextrocardia: Situs type matters. Ochsner J. 2021;21(1):111–4.

    Article  Google Scholar 

  31. Rapoport Y, Fox CJ, Khade P, Fox ME, Urman RD, Kaye AD. Perioperative implications and management of dextrocardia. J Anesth. 2015;29(5):769–85.

    Article  Google Scholar 

  32. Fulcher AS, Turner MA. Abdominal manifestations of situs anomalies in adults. Radiographics. 2002;22(6):1439–56.

    Article  Google Scholar 

  33. Yeo L, Luewan S, Markush D, Gill N, Romero R. Prenatal diagnosis of dextrocardia with complex congenital heart disease using fetal intelligent navigation echocardiography (FINE) and a literature review. Fetal Diagn Ther. 2018;43(4):304–16.

    Article  Google Scholar 

  34. Walmsley R, Hishitani T, Sandor GGS, Lim K, Duncan W, Tessier F, et al. Diagnosis and outcome of dextrocardia diagnosed in the fetus. Am J Cardiol. 2004;94(1):141–3.

    Article  Google Scholar 

  35. Offen S, Jackson D, Canniffe C, Choudhary P, Celermajer DS. Dextrocardia in adults with congenital heart disease. Heart Lung Circ. 2016;25(4):352–7.

    Article  Google Scholar 

  36. Sharma P, Nagarajan V, Underwood DA. Heart on the right may sometimes be “right”. Cleve Clin J Med. 2015;82(4):206–8.

    Article  Google Scholar 

  37. Abd Elrazek AE, Shehab A, Elnour AA, Al Nuaimi SK, Baghdady S. Colon in the chest: An incidental dextrocardia A case report study. Medicine (Baltimore). 2015;94(6):e507.

    Article  Google Scholar 

  38. Yusuf SW, Durand JB, Lenihan DJ, Swafford J. Dextrocardia: an incidental finding. Tex Heart Inst J. 2009;36(4):358–9.

    Google Scholar 

  39. Ogunlade O, Ayoka AO, Akomolafe RO, Akinsomisoye OS, Irinoye AI, Ajao A, et al. The role of electrocardiogram in the diagnosis of dextrocardia with mirror image atrial arrangement and ventricular position in a young adult Nigerian in Ile-Ife: a case report. J Med Case Rep. 2015;9(1):222.

    Article  Google Scholar 

  40. Garg N, Agarwal BL, Modi N, Radhakrishnan S, Sinha N. Dextrocardia: an analysis of cardiac structures in 125 patients. Int J Cardiol. 2003;88(2–3):143–55. discussion 155-6

    Article  Google Scholar 

  41. Huhta JC, Hagler DJ, Seward JB, Tajik AJ, Julsrud PR, Ritter DG. Two-dimensional echocardiographic assessment of dextrocardia: a segmental approach. Am J Cardiol. 1982;50(6):1351–60.

    Article  CAS  Google Scholar 

  42. Ji Y-Q, Sun P-W, Hu J-X. Diagnosis and surgical treatment of congenital dextrocardia. Di Yi Jun Yi Da Xue Xue Bao. 2002;22(6):536–8.

    Google Scholar 

  43. Duong SQ, Godown J, Soslow JH, Thurm C, Hall M, Sainathan S, et al. Increased mortality, morbidities, and costs after heart transplantation in heterotaxy syndrome and other complex situs arrangements. J Thorac Cardiovasc Surg. 2019;157(2):730–740.e11.

    Article  Google Scholar 

  44. Chang YL, Wei J, Chang C-Y, Chuang Y-C, Sue S-H. Cardiac transplantation in situs inversus: two cases reports. Transplant Proc. 2008;40(8):2848–51.

    Article  CAS  Google Scholar 

  45. Guo G, Yang L, Wu J, Sun L. Implantation of VVI pacemaker in a patient with dextrocardia, persistent left superior vena cava, and sick sinus syndrome: A case report: A case report. Medicine (Baltimore). 2017;96(5):e6028.

    Article  Google Scholar 

  46. Karigyo CJT, Batalini F, Murakami AN, Teruya RT, Gregori JF. Off-pump triple coronary artery bypass grafting in a patient with situs inversus totalis: Case presentation and a brief review of the Brazilian and the international experiences. Braz J Cardiovasc Surg. 2016;31(2):198–202.

    Google Scholar 

  47. Maldjian PD, Saric M. Approach to dextrocardia in adults: review. AJR Am J Roentgenol. 2007;188(6 Suppl):S39–49. quiz S35-8

    Article  Google Scholar 

  48. Nesta M, Mazza A, Perri G, Bruno P, Massetti M. Repair of posterior infarct ventricular septal defect in a patient with dextrocardia and situs inversus: Repair of septal defect in dextrocardia. J Card Surg. 2016;31(3):147–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Shifa College of Medicine, Shifa Tameer e Millat University, Islamabad, Pakistan

    Ibad Ur Rehman

  2. Al Nafees Medical College, Isra University, Islamabad, Pakistan

    Khadija Iqbal

  3. Kabir Medical College, Gandhara University, Peshawar, Pakistan

    Irfan Ullah

Authors
  1. Ibad Ur Rehman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Khadija Iqbal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Irfan Ullah
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Aristotle University of Thessaloniki, Thessaloniki, Greece

    Georgios Tagarakis

  2. Aarhus University, Aarhus, Denmark

    Ahmed Gheni Sarfan

  3. University of Baghdad, Baghdad, Iraq

    Hashim Talib Hashim

  4. American University of the Caribbean School, Cupecoy, Sint Maarten (Dutch part)

    Joseph Varney

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rehman, I.U., Iqbal, K., Ullah, I. (2023). Dextrocardia. In: Tagarakis, G., Gheni Sarfan, A., Hashim, H.T., Varney, J. (eds) Clinical and Surgical Aspects of Congenital Heart Diseases . Springer, Cham. https://doi.org/10.1007/978-3-031-23062-2_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-23062-2_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-23061-5

  • Online ISBN: 978-3-031-23062-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics