Dextrocardia: Causes, Symptoms, Diagnosis and Treatment

We all know that our heart is situated on the left side of our body, but have you ever heard of someone who has his or her heart on the right side. Shocking isn’t it? Well although this is unbelievable and cent percent true! In this world there are a few people whose hearts are situated on the right side and this state is known as Dextrocardia.

Dextrocardia also known as Detroversion, Dextroposition or Dextrorotation is a state in which heart is situated on the right side of the body rather than the left. It could be since birth caused due to a disease or may be surgery.

Causes

There are various causes to this disorder:
The development of the heart happens during the early stages of pregnancy. At times due to reasons not known to man kind the heart develops on the right side instead of the left side of the chest. There are many kinds of dextrocardia and many involve other defects of the abdomen and heart area. The simplest form of dextrocardia is the one where the heart is a reflection (mirror image) of a normal person’s heart and there is existence of no problem. Moreover in such a case the lungs and other abdominal organs too will be arranged in a similar manner. For instance, the liver placed on the left side instead of the right.  However this form of dextrocardia is rare, there are some individuals with mirror-image dextrocardia who do have trouble with cilia.

In certain forms of dextrocardia, besides abnormal positioning of the heart, certain heart defects such as Double outlet right ventricle, Transposition of the great vessels, Pulmonary stenosis or atresia, Single ventricle, Ventricular septal defect and Endocardial cushion defect are seen.

Heterotaxy, refers to organs not seen in their normal place, is a serious condition that can occur along with dextrocardia. At times the organs in the chest and abdominal area of infants with dextrocardia may not be normal and may function wrongly. An Infant with Heterotaxy may face complications where spleen, a very important element of the immune system that averts bacterial infection may be missing or the infant may have many tiny spleens that may not function properly.

Other defects associated with Heterotaxy are:

  • Problems with lungs
  • Abnormal gallbladder structure
  • Abnormal formation of the Intestines
  • Major heart defects

Potential risk for dextrocardia comprises of:

  • Mother with diabetes (may perhaps play a part in certain types of dextrocardia)
  • Family history of the condition

Symptoms

Incase the heart functions normally there are no symptoms for dextrocardia, but certain conditions may cause the symptoms mentioned below:

  • Difficulty in breathing
  • Bluish skin
  • Failure to gain weight and stagnant growth
  • Jaundice (yellow eyes and skin)
  • Fatigue
  • Constant lung infections or sinus
  • Pale skin (pallor)

Diagnosis

There are no signs of abnormality seen during examination if the heart functions normally however certain conditions may show the following signs:

  • Enlarged heart
  • Abnormal structure and arrangement of the abdominal organs
  • Rapid breathing or problems while breathing
  • Problems with the formation of the lungs and chest that can be seen on the x-rays
  • Rapid pulse

Following tests that can diagnose dextrocardia are:

  • (CT) Computed tomography scans
  • (MRI) or Magnetic resonance imaging of the heart
  • X-rays
  • Echocardiogram or Ultrasound of the heart

Treatment

There is no treatment needed for a complete mirror image dextrocardia that has no heart or abdominal defects. However it is necessary for the child’s doctor to know that the child has his or her heart on the right side instead of the left. This data is imperative during certain tests and examination.
Treatment for people with dextrocardia depends on if the person has certain physical or heart problems along with dextrocardia. In case there are heart defects along with dextrocardia, then there is a need for surgery. If the infant is very weak then medication is needed prior to surgery. These medicines help the baby to grow stronger so that surgery can be performed.

Medications consist of:

Medications that assist the heart muscle pump with force (inotropic agents)
“Water pills” (diuretics)
Medications which lower the blood pressure and relieve the work load off the heart (ACE inhibitors)
Infant with defective abdominal organs may also need surgery in order to help them function properly. Kids with Kartagener syndrome would require constant antibiotic treatment for sinus infections. Kids with abnormal or missing spleen would require antibiotic treatment for a very long period or may be life time. All children with heart defects must take antibiotics prior to dental treatment or surgeries.

Prognosis

Infants with simple dextrocardia mostly lead a normal life and usually have no complications with regard to their heart’s location. In case there is a defect seen in the heart or other parts of the body along with dextrocardia, the well being of the infant depends on how severe the problems are. High Death rate is recorded for kids and infants without spleen as there is a very high chance of severe infections.

Possible Complications

Complications could be:

  • Blocked intestines
  • Bacteria in the blood (septic shock)
  • Death
  • Congestive heart failure
  • Infertility in males (Kartagener syndrome)
  • Infection (heterotaxy with no spleen)
  • Constant sinus infections (Kartagener syndrome)
  • Recurring pneumonias

Time to contact your child specialist

You will need to call your child’s doctor if your kid

  • Does not appear to gain weight
  • frequently falls ill
  • Tires easily

You may need to seek emergency care in case your kid has:

  • Trouble in breathing
  • A bluish tinge on the skin
  • Yellow skin (jaundice)

Prevention:

Certain disorders that may accompany dextrocardia could be hereditary. In case heterotaxy is hereditary in your family then is advisable that you consult your doctor prior to getting pregnant. As there are no known ways for preventing dextrocardia, avoiding the usage of illegal drugs like cocaine prior to and in pregnancy can help in lowering the risks of this defect. In case you are diabetic then it is advisable that you consult you doctor as it can add to your risk of conceiving a baby with certain types of dextrocardia.