Dextrocardia (from Latin dexter, meaning “right,” and Greek kardia, meaning “heart”) is a rare congenital defect in which the apex of the heart is located on the right side of the body. There are two main types of dextrocardia: dextrocardia of embryonic arrest (also known as isolated dextrocardia) and dextrocardia situs inversus. Dextrocardia situs inversus is further divided.
Dextrocardia of embryonic arrest
In this form of dextrocardia, the heart is simply placed further right in the thorax than is normal. It is commonly associated with severe defects of the heart and related abnormalities including pulmonary hypoplasia.
Dextrocardia situs inversus
Although statistically people with dextrocardia situs inversus do not have any medical problems from the disorder, they may be prone to a number of bowel, esophageal, bronchial and cardiovascular disorders (such as double outlet right ventricle, endocardial cushion defect and pulmonary stenosis). Certain cardiovascular and pulmonary disorders related to dextrocardia can be life-threatening if left unchecked (see reference).
Technical dextrocardia refers to an ECG reading that has no basis in the patient’s anatomy. This apparent presentation of dextrocardia is caused usually by the technician inadvertently swapping the limb leads on a 12 lead ECG. Usually this would show as an extreme axis deviation.
ECG leads must be placed in reversed positions on a person with dextrocardia. In addition, when defibrillating someone with dextrocardia, the pads should be placed in reverse positions. That is, instead of upper right and lower left, pads should be placed upper left and lower right.
Dextrocardia is believed to occur in approximately 1 in 12,019 pregancies.
- Stephenson, Susan (2012). Diagnostic Medical Sonography Obstetrics and Gynecology. 351 West Camden Street Baltimore, MD 21201: Lippincott Williams & Wilkins. p. 582.
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- Bindra, S. MD; Tabibiazar, R. MD; Mazar, M MD & Dave, R MD (2011). “Clinical Vignette: Dextrocardia with Situs Inversus: Through the Looking Glass with an ECG”. Proceedings of UCLA Healthcare. Department of Medicine, UCLA. 15.
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- MedEd at Loyola GrossAnatomy/thorax0/Heart_Development/Dextrocardia.html
- Overview at rch.org.au
- Dextrocardia at NIH‘s Office of Rare Diseases
- Dextrocardia with situs inversus at NIH‘s Office of Rare Diseases