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Alternative Names Return to topDetroversion; Dextroposition; Dextrorotation
Definition Return to top
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.
Causes Return to top
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:
Possible risk factors for dextrocardia include:
Symptoms Return to top
There are no symptoms of dextrocardia if the heart is normal.
Conditions that may include dextrocardia may cause the following symptoms:
Exams and Tests Return to top
There are no signs of dextrocardia if the heart is normal.
Conditions that can include dextrocardia may cause the following signs:
Tests to diagnose dextrocardia include:
Treatment Return to top
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.
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.
See also: Congenital heart defect corrective surgery
Outlook (Prognosis) Return to top
Babies with simple dextrocardia have a normal life expectancy and should have no problems related to the location of the heart.
When dextrocardia appears with other defects in the heart and elsewhere in the body, how well the baby does depends on the severity of the problems.
The death rate in babies and children without a spleen may be very high, due to infections.
Possible Complications Return to top
Complications depend on whether dextrocardia is part of a larger syndrome, and whether other problems exist in the body. Complications include:
When to Contact a Medical Professional Return to top
Call your health care provider if your baby:
Seek emergency care if your baby has:
Prevention Return to top
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 Return to top
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.Update Date: 4/30/2008 Updated 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.