Dextrocardia is a rare congenital condition in which the heart is positioned on the right side of the chest rather than the left. In the most common form (situs inversus with dextrocardia), all of the thoracic and abdominal organs are mirrored, with the liver on the left and the spleen on the right. This mirror-image arrangement can be associated with a structurally normal heart and normal life expectancy.
However, dextrocardia can also occur in isolation, with the heart rotated to the right but the rest of the organs in their normal positions (situs solitus with dextrocardia). This form is more commonly associated with structural heart defects and requires careful investigation.
For most people with dextrocardia and no structural heart disease, the condition is discovered incidentally on chest X-ray (where the cardiac shadow appears on the right) or ECG (where leads appear reversed). It does not usually cause symptoms or require treatment. However, the mirror-image anatomy has important clinical implications: the ECG will appear abnormal (with reversed lead placements), and during cardiac arrest resuscitation, emergency clinicians need to be aware of the altered anatomy when placing defibrillation pads, interpreting rhythms, and performing procedures.
A small subset of people with dextrocardia have an associated condition called primary ciliary dyskinesia (Kartagener syndrome), which also affects the respiratory system and fertility. All patients with dextrocardia should have a baseline echocardiogram to exclude associated structural abnormalities, and should inform their cardiologist and GP so that appropriate adjustments can be made to clinical procedures.
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