Pediatric Dextrocardia

Pediatric Dextrocardia

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What is dextrocardia?

Dextrocardia occurs when a child’s heart is located on the right side of the chest instead of the left. There are several different types of dextrocardia.

Expanded Overview

A child’s heart is normally located toward the left side of the chest, but with dextrocardia, it is to the right. “Dextro” means “right” in Latin. In its simplest form – known as isolated dextrocardia – the heart functions and looks just like a healthy heart, even though it is on a different side. In other cases, the changes can be more complex and cause additional complications.

If a child is diagnosed with dextrocardia, these other conditions can occur alongside the different heart structure:

  • Aorta and pulmonary artery locations are switched
  • Aorta connects to the right ventricle instead of the left ventricle
  • Hole in the wall that separates the right and left ventricles, known as ventricular septal defect
  • Narrowing or malformation of the pulmonary valve
  • Single ventricle instead of two ventricles
  • Walls separating the four chambers of the heart may be poorly formed or absent

Other related conditions include:

  • Kartagener syndrome ­– a child with dextrocardia may also have Kartagener syndrome, in which the cilia (tiny hairs) in the nose and lungs that sweep away germs don’t work correctly.
  • Missing spleen – a child with dextrocardia may also be missing a spleen, which is a critical component of the immune system, thus causing them to be sick more often.

What are the types of dextrocardia?

There are several types of dextrocardia, including:

  • Isolated dextrocardia – This is the simplest form of dextrocardia. In these children, the heart is located further right in the chest than usual, but they do not exhibit other medical concerns.
  • Dextrocardia with situs inversus – 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 are also reversed, looking like a mirrored image of the normal locations of the organs.
  • Dextrocardia situs inversus totalis – In these children, all organs in the chest and abdomen (visceral organs) are mirrored.

What causes dextrocardia?

Pediatric dextrocardia is congenital, meaning a child is born with it and it occurs while the baby is developing in their mother’s womb. A genetic mutation causes dextrocardia, but it has not been conclusively linked to an inherited trait. 

What are the symptoms of dextrocardia?

Some children experience no symptoms if they have isolated dextrocardia. An imaging scan that is ordered for another reason may reveal the condition.

If dextrocardia is coupled with other conditions or complications, symptoms can include:

  • Bluish skin or lips from lack of oxygen
  • Breathing difficulties
  • Failure to grow
  • Fatigue (extreme tiredness)
  • Holes in the septum (divides the right and left side of heart)
  • Jaundice (yellowing of skin)
  • Lung infections
  • Missing spleen
  • Sinus infections

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