DEFINITION OF DEXTROCARDIA
Dextrocardia is a rare congenital condition where the heart points toward the right side of the chest instead of the left. The condition is usually not life-threatening, although it often occurs alongside more serious complications, such as heart defects and organ disorders in the abdomen.
There are two major types of dextrocardia, namely;
- Dextrocardia situs inversus
In this type of dextrocardia, the tip of the heart and its four chambers are pointing towards the
right side of the body. In these children, the heart is a mirrored image and located to the right.
The rest of the organs in the chest and abdominal cavity is also reversed, looking like a mirrored image of the normal locations of the organs.
- Dextrocardia with situs inversus totalis
With this type of dextrocardia, abdominal and chest organs and other vessels, such as the liver, stomach, and spleen are also out of position. In fact, the other organs are in the opposite position, or in mirror-image reversal, to where they should be.
CAUSES AND RISK FACTORS
- Non-dominant (also called autosomal recessive) genes cause dextrocardia. These abnormal genes cause the primitive, or cardiac, tube to reverse direction while a fetus is developing in the womb.
- Dextrocardia affects an estimated 1 out of every 12,000 people. Dextrocardia situs inversus totalis affects approximately 1 out of every 10,000
SIGNS AND SYMPTOMS
- Many people with congenital dextrocardia do not always know they have it, as the condition may not produce many symptoms.
- One telltale symptom of dextrocardia is that people with this condition have maximum heart sounds on the right of the chest instead of the left.
- In severe cases, Symptoms that require medical attention include:
- unexplained and continual exhaustion
- inability to gain weight
- chronic infections, especially of the sinus and lungs
- difficulty breathing
- jaundiced or yellowed skin
- blue-tinted skin, especially around the fingers and toes
Most cases of dextrocardia are diagnosed using
- Electrocardiogram (EKG): An EKG that shows inverted or reversed electrical waves usually points to dextrocardia.
- Chest X-ray.
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan to confirm the condition
- Heterotaxy; many of the organs are not in their usual place and may not be working properly
- Congenitally corrected transposition of the great arteries (CCTGA)
- This condition occurs when the lower half of the heart is reversed, specifically the lower ventricles and the connected valves.
- Tricuspid atresia
- This condition is a congenital defect where the tricuspid valve fails to develop. The tricuspid valve prevents blood from flowing back into the right atrium from the right ventricle.
- Pulmonary stenosis or atresia
- This occurs when the pulmonary (pulmonic) valve of the heart that allows blood to leave the heart narrows (stenosis) or fails to develop (atresia).
- Kartagener syndrome; Roughly 20 percent of those with dextrocardia also have Kartagener syndrome.
- Other complications associated with dextrocardia may include:
- bowel and esophageal disorders, usually from obstruction due to malrotation (reversal)
- bronchial diseases, such as chronic pneumonia, associated primarily with a loss of cilia (hair-like projections) from mucosal tissues
- infection and sepsis
- Many people with dextrocardia do not display symptoms so the condition can go untreated.
- Infants with dextrocardia, which is accompanied by heart defects, may require surgery. Many children will be given medication that increases the force of the heartbeat and lowers their blood pressure before surgery.
- For those with Kartagener syndrome, treatment of sinus and lung symptoms may help lessen the chances or impact of dextrocardia.
- Genetic counseling may be helpful for those with dextrocardia who are looking to start a family.
Treatment options include:
- expectorant or mucous clearing medications
- antibiotics for bacterial infections
- treating cases of bronchitis and sinusitis
For most people with dextrocardia situs inversus, life expectancy is normal. In cases of isolated dextrocardia, congenital heart defects are more frequent and associated with greater health risks.