Dextrocardia is a rare congenital heart condition in which your heart is in the right side of your chest and points to the right. Typically, your heart is on your left side and points to the left. Dextrocardia only needs treatment if other heart issues or genetic syndromes are causing problems. Surgery may be needed depending on the issues.
Dextrocardia is a condition in which your heart is located in the right side of your chest and points to the right. Normally, your heart is in the left side of your chest and points to the left.
Dextrocardia is congenital, meaning it’s a condition you or your child have at birth. Some people with dextrocardia have no problems or complications. They learn by accident that they have it. Others have congenital heart defects or syndromes that cause symptoms and complications. How dextrocardia affects a person’s body depends on the type they have.
Some people have dextrocardia in isolation. That means your heart is flipped from left to right but all other organs are arranged normally. However, most people have dextrocardia along with other issues. Below are the different types of dextrocardia:
Heart defects found in people with dextrocardia include:
Dextrocardia was one of the earliest congenital heart malformations identified by scientists. It was first identified in the 1600s and written about in the 1700s. Over the years, we’ve learned more about this condition and how it connects with other syndromes.
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Many people with dextrocardia have an additional congenital syndrome including:
Associated syndromes and heart defects cause problems for people with dextrocardia. These issues often need treatment or long-term care.
Dextrocardia is a right-sided cardiac malposition. This means your heart is in the right side of your chest when it should be in the left side. Other right-sided cardiac malpositions include dextroposition and dextroversion. The names sound very similar, so it’s easy to get them confused. Here’s what each term means:
Dextrocardia is a rare congenital heart condition. It occurs in about 1 in every 12,000 pregnancies.
People with isolated dextrocardia have no symptoms. But other conditions can cause a range of symptoms. Symptoms in babies and children include:
Adults with dextrocardia may have no symptoms. But heart defects and associated syndromes may cause symptoms. They vary based on your diagnosis. Talk with your healthcare provider to learn more about symptoms and how to manage them.
Dextrocardia appears to be caused by genetic changes early in pregnancy. More than 60 genes play a role in how your organs are positioned in your body. Researchers are still looking for the specific gene that causes dextrocardia.
About 1 in 4 people with dextrocardia also have primary ciliary dyskinesia. Mutations in more than 30 different genes, including DNAI1 and DNAH5, can cause this genetic disorder. Some people can be a “carrier,” meaning they have a genetic mutation but no symptoms of the condition. If both your parents are carriers, you have a 25% chance of having primary ciliary dyskinesia (with symptoms) and a 50% chance of being a carrier.
Dextrocardia may be diagnosed during pregnancy through prenatal ultrasound. But your child may need imaging tests later to confirm. Children without symptomatic heart defects or genetic syndromes may not be diagnosed with dextrocardia until years later.
A physical exam might diagnose dextrocardia. Your healthcare provider uses a stethoscope to listen to your heart or your child’s heart. A noticeable heartbeat on the right side of the chest can be a sign of dextrocardia.
Tests that diagnose dextrocardia include:
Your provider may recommend genetic testing and other tests to check for syndromes.
An electrocardiogram (ECG/EKG) reading can show if you have dextrocardia. ECG tests create a picture of your heart’s electrical activity, which has a normal graph when the heart is in its normal location on the left. The graph will look different than usual if your heart’s location is unusual — as is the case with dextrocardia (the right side of your chest).
ECG graphs follow predictable patterns. You might hear your provider talk about the three waves of electrical activity. These are the bumps and spiky points on each line of the graph. The first small bump is called the “P wave.” It shows your heart’s pacemaker, or the electrical signal that tells your heart to beat. Next, there’s a sharp spike called the “QRS complex." This shows your strongest heartbeat as your left ventricle pushes blood out to your body. The “T wave” shows your heart’s brief relaxation before the next heartbeat.
Dextrocardia causes ECG readings with waves that are flipped in the opposite direction. The P wave, QRS complex and T wave point downward rather than upward. This could happen if the ECG electrodes are in the wrong spots. So sometimes the provider giving the test may run it again to make sure the reading is accurate. But if this “different” ECG comes up again, it can signal dextrocardia.
Ask your provider to discuss your or your child’s ECG reading with you and explain what it means.
Treatment for dextrocardia depends on which heart defects or syndromes you have.
If you have dextrocardia with no heart defects, you don’t need treatment. But it’s important to share this diagnosis with any healthcare providers giving you care. This information can be helpful for them to know during certain tests and procedures.
People with heart defects often need surgery. Such surgeries may happen early in infancy or childhood. Some babies need to take medicine leading up to the surgery including:
The specific type of surgery your baby needs depends on their congenital heart defect. Your child’s provider will discuss treatment options with you.
Dextrocardia doesn’t need surgery or correction if it’s not causing any problems. But babies born with dextrocardia often have heart defects or genetic syndromes. And those defects or syndromes can prevent a baby’s heart from functioning as it should. In those cases, surgery may be needed.
There’s no specific way to prevent dextrocardia. It’s likely caused by genetic changes that happen early in pregnancy. But prenatal care may impact a baby’s chances of having congenital heart disease. If you’re pregnant or planning a pregnancy, here are some steps you can take:
Talk with your healthcare provider about any concerns you have. Genetic testing may be helpful, especially if you have a biological family history of congenital heart disease.
A person can live with dextrocardia for a long time, but the outlook varies based on other diagnoses. Babies born with isolated dextrocardia (no defects or syndromes) have a normal life expectancy. But babies born with heart defects or genetic syndromes may need treatments or surgeries to manage those conditions. Talk with your healthcare provider about what to expect and the long-term outlook.
Complications depend on the defects and syndromes you have along with dextrocardia. They vary widely based on the individual but can include:
If your child has dextrocardia, talk with their healthcare provider about what to expect. You may need to look for symptoms related to heart defects or syndromes including:
Call 911 if your child:
If you have dextrocardia, talk with your healthcare provider about how other conditions may affect your body. Your provider will tell you which symptoms to look for and how to manage them. Call your provider any time you have questions or concerns.
If your child was diagnosed with dextrocardia, you probably have many questions. Your child's healthcare provider will share resources and give you plenty of information. You may also want to ask:
A note from Cleveland Clinic
Dextrocardia is usually diagnosed along with other medical conditions. If your child has dextrocardia, their healthcare provider will discuss whether they need treatment. It’ll depend on your child’s heart function and whether other conditions are causing problems. Your child’s healthcare team will work with you every step of the way. It’s also helpful to connect with other parents who have children with heart problems. Building a supportive community can make a huge difference as you care for your child.
Last reviewed by a Cleveland Clinic medical professional on 05/10/2022.
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