Dextrocardia

Dextrocardia is a congenital condition in which the heart is located on the right side of the chest, with the apex oriented to the right. It may occur with normal positioning of other organs (situs solitus), or as part of a mirror-image arrangement known as situs inversus totalis. A third category, heterotaxy or situs ambiguus, involves abnormal positioning of multiple organs and is often associated with congenital heart defects.

Embryologically, dextrocardia results from abnormal looping of the heart tube during early development, which alters laterality and places the heart on the right side.

Diagnosis is typically revealed on imaging or incidentally. Chest radiographs show a rightward cardiac silhouette; electrocardiography may show axis reversal or abnormal waveforms when standard limb leads are used. Echocardiography, computed tomography, or magnetic resonance imaging clarifies the cardiac and visceral anatomy and identifies any associated congenital heart disease.

Most people with dextrocardia are asymptomatic. When symptoms occur, they are usually due to opposite-sided heart function or to concomitant heart defects; in situs inversus with Kartagener syndrome, chronic sinusitis and bronchiectasis may be present. Management depends on anatomy: isolated dextrocardia without significant heart disease generally requires no treatment, while congenital heart defects may require medical or surgical intervention. Awareness of organ reversal is important during procedures and ECG interpretation.

Dextrocardia is rare and present from birth; long-term prognosis depends on associated anomalies and overall cardiac function.