What is the problem with dextrocardia?

Humans are indeed a marvel creature. Many cells and organs located in their position work in a manner and form a system. All of the body systems work in order and are able to adapt when there are changes in the body or changes to the environment that affect the way the body works. This helps humans to live and survive throughout their life. In this DoctorOnCall’s article, we will be learning about dextrocardia, which is a disease characterised by the organs in the body to be located at the different side which is unusual for a normal human.

Dextrocardia is defined as the heart pointed towards the right side of the chest. In a normal human, the heart is pointed towards the left. This means that dextrocardia causes the heart to be located in the right side of the chest (thoracic cavity) which is opposite of the heart’s position in a normal human. Dextrocardia is a rare congenital disorder that occurs at birth. It is usually associated with other birth defects. It can occur by itself or be accompanied with organs positioned in reversal. In most cases, dextrocardia is diagnosed accidentally when a person is getting checked or examined for other health problems.

Dextrocardia is a very rare condition as the occurrence of this is around 1 in 12 000 people. Both boys and girls have the same probability of being born with dextrocardia. There are several major types of dextrocardia. In isolated dextrocardia, only the heart is on the opposite side of the body and this is very rare. Dextrocardia situs inversus not only involves the heart to be positioned on the right, but also involves some of other organs to be on the opposite side of the body such as the liver on the left side instead of the right side and spleen on the right side instead of left side as the normal positions. In dextrocardia situs inversus totalis, all the vital organs in the chest and abdomen are on the opposite side of the body compared to the normal location. Dextrocardia often presents with other heart defects. This may include:

  • Double outlet right ventricle (aorta connects to the right ventricle)
  • Endocardial cushion defect (poorly formed wall separating the 4 heart chambers)
  • Ventricular septal defect (presence of abnormal hole in the wall separating right and left ventricles)
  • Single ventricle (normal heart have two ventricles)
  • Pulmonary stenosis (narrowing of the pulmonary valve)

Transposition of the great vessels (the big blood vessels of aorta and pulmonary artery are in switched position)

The causes for dextrocardia are not entirely known but one thing for certain, it occurs during the fetus development. This means that it occurs during pregnancy. Embryonic development may have caused the abnormal position of the organs. Inherited disorders such as Kartagener syndrome and heterotaxy can cause dextrocardia. Kaartagener syndrome, also known as primary ciliary dyskinesias, is a rare genetic disorder comprising chronic sinusitis (inflammation of the space lining the inside the nose and head) situs inversus (reversed internal organs) and bronchiectasis (permanent enlargement of the always of the lung). Heterotaxy is a rare condition causing the organs in the chest and abdomen to form abnormally, positioned wrongly or missing.

Due to the fact that it is a health condition that is most commonly found accidentally, you may wonder what is the problem with dextrocardia if a person can live that long before the condition is discovered. Ironically, isolated dextrocardia is a benign condition that is often associated with other birth defects (congenital anomalies). However, the problem is that this will lead to several problems such as breathing difficulties and recurrent infections due to the abnormal organs working incorrectly. The problem does not stop when the patient is still young as adults with dextrocardia might also have infertility issues.

Although there are problems, parents should not be panicked or overly worried when their child is diagnosed with dextrocardia. With isolated dextrocardia, patients can live normally just as other normal people without any complications. Dextrocardia with other conditions may have had a serious effect on the hearts and other vital organs. It is usually not a life-threatening condition even if it may lead to serious complications. It is important for patients with dextrocardia to get treated and receive medical care.

Treatment depends on the type of dextrocardia and its severity. Dextrocardia with no symptoms usually does not need any surgery. Dextrocardia with heart defects will be considered for surgical reconstructions or heart transplantations. Supportive treatment such as prescription cough medication and antibiotics is common in those with Kaartagener syndrome to help manage their symptoms and infections respectively. Medications to help optimise heart functions may be given.

It can be concluded that those diagnosed with dextrocardia can strive and live. It is a rare disease that is identified accidentally unless in babies with symptoms such as from heart defects or other vital organs misalignment.

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