About mirror-image dextrocardia

What is mirror-image dextrocardia?

Dextrocardia with Situs Inversus is a rare heart condition characterized by abnormal positioning of the heart. In this condition, the tip of the heart (apex) is positioned on the right side of the chest. Additionally, the position of the heart chambers as well as the visceral organs such as the liver and spleen is reversed (situs inversus). However, most affected individuals can live a normal life without associated symptoms or disability.

What are the symptoms for mirror-image dextrocardia?

There are no symptoms of dextrocardia if the heart is normal.

Conditions that may include dextrocardia may cause the following symptoms:

What are the causes for mirror-image dextrocardia?

During the early weeks of pregnancy, the baby's heart develops. Sometimes, it turns so that it points to the right side of the chest instead of the left side. The reasons for this are unclear.

There are several types of dextrocardia. Many types involve other defects of the heart and abdomen area.

In the simplest type of dextrocardia, the heart is a mirror image of the normal heart and there are no other problems. This condition is rare. When this occurs, the organs of the abdomen and the lungs will often also be arranged in a mirror image. For example, the liver will be on the left side instead of the right.

Some people with mirror-image dextrocardia have a problem with the fine hairs (cilia) that filter the air going into their nose and air passages. This condition is called Kartagener syndrome.

In the more common types of dextrocardia, other heart defects are also present. The most common of these include:

  • Double outlet right ventricle (the aorta connects to the right ventricle instead of to the left ventricle)
  • Endocardial cushion defect (the walls separating all 4 chambers of the heart are poorly formed or absent)
  • Pulmonary stenosis (narrowing of the pulmonary valve) or atresia (pulmonary valve does not form properly)
  • Single ventricle (instead of two ventricles, there is a single ventricle)
  • Transposition of the great vessels (the aorta and pulmonary artery are switched)
  • Ventricular septal defect (hole in the wall that separates the right and left ventricles of the heart)

The abdominal and chest organs in babies with dextrocardia may be abnormal and may not work correctly. A very serious syndrome that appears with dextrocardia is called heterotaxy. In this condition, many of the organs are not in their usual places and may not work properly. For example, the spleen may be completely missing. The spleen is an important part of the immune system, so babies born without this organ are in danger of severe bacterial infections and death. In another form of heterotaxy, several small spleens exist, but they may not work correctly.

Heterotaxy may also include:

  • Abnormal gallbladder system
  • Problems with the lungs
  • Problems with the structure or position of the intestines
  • Severe heart defects
  • Abnormalities of the blood vessels

Possible risk factors for dextrocardia include a family history of the condition.

What are the treatments for mirror-image dextrocardia?

A complete mirror image dextrocardia with no heart defects requires no treatment. It is important, however, to let the child's health care provider know the heart is on the right side of the chest. This information can be important in some exams and tests.

The type of treatment needed depends on the heart or physical problems the infant may have in addition to dextrocardia.

If heart defects are present with dextrocardia, the baby will most likely need surgery. Babies who are very ill may need to take medicines before they can have surgery. These medicines help the baby grow larger so surgery is easier to perform.

Medicines include:

  • Water pills (diuretics)
  • Drugs that help the heart muscle pump more forcefully (inotropic agents)
  • Drugs that lower blood pressure and ease the workload on the heart (ACE inhibitors)

The baby might also need surgery to correct problems in the organs of the abdomen.

Children with Kartagener syndrome will need repeated treatment with antibiotics for sinus infections.

Children with a missing or abnormal spleen need long-term antibiotics.

All children with heart defects may need to take antibiotics before surgeries or dental treatments.

What are the risk factors for mirror-image dextrocardia?

Mirror-image dextrocardia, the most prevalent type of cardiac malposition encountered, is dextrocardia, which is almost always linked to situs inversus of the abdominal organs. The aortic arch curves to the right and posteriorly, and the anatomic right ventricle is ahead of the left ventricle. On the left side is the three-lobed anatomic right lung. In general, the risk of an infracardiac malformation is not increased.

Risk factors for mirror-image dextrocardia

  • Gender, race, and ethnicity don't seem to matter in terms of whether someone gets the mirror-image dextrocardia or not. Risk factors for mirror-image dextrocardia involve:
  • Dextrocardia is brought on by non-dominant (also known as autosomal recessive) genes.
  • While a fetus is growing in the womb, these abnormal genes cause the primitive, or cardiac, tube to reverse direction.
  • The development of the heart and abdominal organs may also be reversed, depending on the degree and timing of the reversal.
  • Dextrocardia is caused by recessive genes, so for someone to have the condition, both of their parents must pass on a copy of the abnormal gene.
Symptoms
Bluish skin,Difficulty breathing,Failure to grow and gain weight,Fatigue,Jaundice (yellow skin and eyes),Pale skin (pallor),Repeated sinus or lung infections
Conditions
Blocked intestines (due to a condition called intestinal malrotation),Heart failure,Infection (heterotaxy with no spleen),Infertility in males (Kartagener syndrome),Repeated pneumonias,Repeated sinus infections (Kartagener syndrome)
Drugs
Diuretics,Inotropic agents,ACE inhibitors

Is there a cure/medications for mirror-image dextrocardia?

There is no need for treatment if the dextrocardia has a complete mirror image and no heart defects. However, it is crucial to inform the doctor that the heart is located on the right side of the chest.

In some exams and tests, this information may be crucial. If dextrocardia interferes with the proper operation of vital organs, it must be treated.

The heart can function normally with pacemakers and septal defect surgery.

The kind of care required will depend on any additional physical or heart conditions the patient may have.

To prevent infection, your doctor will prescribe antibiotic medications if you don't have a spleen or if it isn't functioning properly.

To combat respiratory illnesses, you might need to take antibiotics for a prolonged period of time.

Blockages in your digestive system are more likely when your heart is positioned with your right side facing outward. This is because mirror-image dextrocardia occasionally causes intestinal malrotation, a condition in which your gut does not develop normally.

Because of this, your doctor will keep an eye out for an intestinal or bowel obstruction, also known as an abdominal obstruction.

Your body can't expel waste due to an obstruction and needs to be treated immediately.

Symptoms
Bluish skin,Difficulty breathing,Failure to grow and gain weight,Fatigue,Jaundice (yellow skin and eyes),Pale skin (pallor),Repeated sinus or lung infections
Conditions
Blocked intestines (due to a condition called intestinal malrotation),Heart failure,Infection (heterotaxy with no spleen),Infertility in males (Kartagener syndrome),Repeated pneumonias,Repeated sinus infections (Kartagener syndrome)
Drugs
Diuretics,Inotropic agents,ACE inhibitors

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