What happens when the heart is on the right side instead of the left?
Dextrocardia is a rare congenital disorder where the heart is located on the right side of the chest. It is often discovered incidentally and can be associated with other developmental anomalies. Dextrocardia involves a change in the orientation of the heart, differentiating it from cardiac dextroposition caused by extracardiac factors. While most patients with dextrocardia lead normal lives without symptoms, management may involve surgical reconstruction if there are associated congenital anomalies. Patients with heart blocks or electrical system abnormalities may require pacemaker evaluation.
Dr. N. Sandeep, Associate Consultant – Cardiology, Manipal Hospitals, Vijayawada.
Dextrocardia is a rare congenital disorder in which the heart resides on the right side of the thoracic cavity. It is often associated with other development anomalies and, in most cases, is diagnosed incidentally. It can occur by itself or can be accompanied by a reversal in the position of other organs (termed situs inverses totalis). When heart is seen in the right side of the chest it can be due to 2 reasons, one is Dextrocardia and the other one is Dextroposition
Dextrocardia also involves a change in the orientation of the heart with its base to the apex axis being directed to the right, in contrast to the normal heart orientation where the apex is directed to the left. This change in orientation differentiates it from cardiac dextroposition, where the heart is displaced to the right side as a result of extracardiac causes, such as a diaphragmatic hernia, right pneumonectomy, or right lung hypoplasia.
Most patients with dextrocardia are asymptomatic and lead a normal life. The management of dextrocardia varies depending on the presence of other congenital anomalies. In patients who have other associated cardiac malformations such as defects of the walls of the heart, malposition of blood vessels, Tetralogy of Fallot, septal defects, severe valvular abnormalities, surgical reconstruction might need to be considered.
Patients with heart blocks and abnormalities of the cardiac electrical system need to be evaluated for pacemaker placement.