Dextrocardia and asplenia in situs inversus totalis in a. Situs solitus describes viscera that are in the normal position, with the stomach on the left side. Pdf we present a rare case of dextrocardia in the corpse of a female child, aged approximately one year old, presenting situs solitus. Situs solitus of viscera and atria was present in 44 cases23 with inverted ventricles, 14 with noninverted ventricles and 7 with common ventricle. Dextrocardia definition of dextrocardia by medical dictionary. Situs solitus is the normal position of thoracic and abdominal organs. The eight adults with situs ambiguous with polysplenia demonstrated a spectrum of abnormalities. In these children, the heart is a mirrored image and located to the right. Such patients may have an interrupted inferior vena cava in. Dextrocardia, dextroversion, dextroposition dextroposition heart is positioned in right thorax, seen in setting of left congenital diaphragmatic hernia dextroversion apex of heart is pointing to right, but situs solitus.
Dextrocardia with situs inversus totalis in an adult. The classification of situs is independent of the cardiac apical position. In dextrocardia with situs solitus, a congenital condition, the heart is on the right side of the chest, but all of the other internal organs are in their normal positions. Shinebourne fromthe departmentofpaediatrics, cardiothoracic institute, bromptonhospital, london summary dextrocardia can be defined as a heart in the right chest with the major axis to the right. Dextrocardia with situs inversus is a rare congenital abnormality involving a lefthanded malrotation of the visceral organs. Systematization and clinical study of dextroversion, mirror. Anatomically, this means that the heart is on the left with the pulmonary atrium on the right and the systemic atrium on the left along with the cardiac apex. In this condition, the tip of the heart apex is positioned on the right side of the chest.
For all visceral organs to be mirrored, the correct term is dextrocardia situs inversus totalis. With situs solitus and situs inversus, the atrial situs always corresponds to the visceral situs 5. There was, in addition, massive mitral in sufficiency, which had not been present when the child was catheterized at 8 years of age. Perioperative implications and management of dextrocardia.
Through the looking glass with an ecg sanjay bindra, m. Situs inversus in 77 47%, situs solitus in 59 36%, and situs ambiguous in 28 17%. Files are available under licenses specified on their description page. Dextrocardia with situs inversus should be differentiated from dextroposition, which means displacement of the heart, most often an acquired condition figure 1266. Dextrocardia refers to the position of the heart in the right side of the chest. Situs ambiguous is a third type of situs in which the arrangement of the organs is not as ordered termed heterotaxy and the relationship between the atria and the viscera is inconsistent. Isolated mirrorimage dextrocardia without situs inversus is extremely rare. Patients with situs inversus and mirrorimage dextrocardia are believed to have normal longevity, and, as these studies suggest, they have the same longterm prognosis after coronary bypass grafting as patients with situs solitus. Dextrocardia with situs inversus is a condition that is characterized by abnormal positioning of the heart and other internal organs. All 10 patients with situs inversus had mirrorimage location of the abdominal organs relative to situs solitus. Congenital heart defects in children with dextrocardia. Associated severe cardiac malformations are typical.
Situs was solitus in 14 74% and inversus in five 26%. Anatomy of a dextrocardia case with situs solitus scielo. Situs solitus is the normal position, and situs inversus is the mirror image of situs solitus. Dec 05, 2014 the arrangements of the position of the abdominal viscera in dextrocardia may be normal situs solitus, reversed situs inversus, and indeterminate situs ambiguous or isomerism in 32 to 35%, 35 to 39% and 26 to 28% of cases respectively. Jun 21, 2019 dextrocardia situs solitus pdf this study had the objective of describing a case of dextrocardia with situs solitus and apexbasis axis inversion in a lesser anteater tamandua. All structured data from the file and property namespaces is available under the creative commons cc0 license. This may sometimes be described as dextrocardia with situs solitus, as a note that all the other organs are where they should be. Dextrocardia and asplenia in situs inversus totalis in a baby.
Secondly, when examining the valve using 2d tee in the midesophageal aortic valve with lax view in a dextrocardia patient, a leftward rotation of the tee probe will examine the posterior portion of the valve a3p3 while in a situs solitus patient, such a leftward rotation would result in the anterior parts of the valve to be examined a1p1. Aug 16, 2019 dextrocardia situs solitus pdf this study had the objective of describing a case of dextrocardia with situs solitus and apexbasis axis inversion in a lesser anteater tamandua. The rest of the organs in the chest and abdominal cavity are also reversed, looking like a mirrored image of the normal locations of the organs. A nineyearold male cocker spaniels dog was referred for cardiologic. An 83 year old female with known dextrocardia presented with dyspnea and was diagnosed with cctga, situs inversus, and new onset heart failure. Situs inversus also called situs transversus or oppositus is a congenital condition in which the major visceral organs are reversed or mirrored from their normal positions. A potentially dangerous form of organ reversal is situs ambiguus sometimes spelled situs ambiguous. Dextrocardia is defined by the authors as a rightsided heart with a baseapex axis directed rightward, resulting from a variation in cardiac development, and not used as a general term indicating. A 56yearold male with history of hypertension, diabetes mellitus type 2 and hypothyroidism presented to the cardiology clinic for evaluation of an abnormal electrocardiogram.
Isolated dextrocardia with situs solitus dextroversion springerlink. The apex is central or rightward displaced on the chest radiograph. Dextrocardia refers to a heart positioned in the right side of the chest. In our patient situs inversus was associated with asplenia and dextrocardia. Pdf dextrocardia with situs inversus, atrioventricular.
Dextrocardia in adults with congenital heart disease heart, lung. Dextrocardia value ofsegmental analysis in its categorisation giuseppe calcaterra, robert h. Dextrocardia is a congenital condition, which is present at birth. Dextrocardia with situs inversus genetic and rare diseases. Medical college, agra pin code282002, india introduction. The incidence of dextrocardia associated to situs inversus in the general population is usually 1. Usually, the liver and stomach appear on the right and left sides of the body, respectively. Apr 24, 2017 if you have isolated dextrocardia, your heart is located on the right side of your chest, but it has no other defects.
Dextrocardia with situs inversus totalis in an adult nigerian. Dextrocardia from latin dexter, meaning right, and greek kardia, meaning heart is a rare congenital condition in which the apex of the heart is located on the right side of the body. It is a rare clinical phenomenon with a reported incidence of 1 in. This induced asymmetry is thought to be achieved by a number of morphological factors that guide development. Dextrocardia can also occur in polysplenia syndrome in up to 50% of cases 12. Dextrocardia with situs inversus is a rare heart condition characterized by abnormal positioning of the heart. Dextrocardia without situs inversus is nearly always associated with other congenital anomalies and is rarely encountered in adults. Eleven patients 58% had functional single ventricles, of whom five had atrioven tricular av. The simplest type occurs when the shape and structure of the heart is a mirror image of a normal heart. Situs solitus, inversus, or ambiguous sidedness determinants. Una dextrocardia con imagen especular completa sin defectos cardiacos no requiere ningun tratamiento. Dextrocardia with situs inversus and associated cardiac. Situs solitus dextrocardia is known to be more associated with chd than situs inversus. Heterotaxy situs ambiguus is the malformation of the chest and abdominal organs found in conjunction with dextrocardia and situs inversus.
When dextrocardia is accompanied with inverted heart atria, a rightsided stomach, and a leftsided liver, the combination is called dextrocardia with situs inversus. Dextrocardia with situs inversus refers to the heart being a mirror image situated on the right side. Visceral situs, heart position, and aortic arch position. In dextrocardia with situs inversus, there is formation of a mirror image of the heart, great vessels and other organs, preserving the relationship between them. The disorders discussed include situs inversus totalis mir rorimage dextrocardia, dextroversion, congenitally corrected transposition of the great arteries, and. Situs inversus wikimili, the best wikipedia reader. Dextrocardia genetic and rare diseases information center. In those with situs inversus totalis, in whom the normal rightversusleft position of all organs is completely reversed, the stomach bubble is also rightsided fig. Like dextrocardia with situs solitus, situs ambiguus occurs in one in 20,000 births source. Jan 14, 2016 dextrocardia is a condition in which the heart is located in the right side of the chest instead of the left. It may be discovered in infancy because of associated anomalies but often remains asymptomatic and discovered by chance in adult life. Dextrocardia with situs inversus associated with non. May 19, 2015 dextrocardia with situs inversus is a condition that is characterized by abnormal positioning of the heart and other internal organs. A heart misplaced in the right chest, with the apex of the heart pointing right.
These patients have situs solitus with congenitally corrected tga 10, 11. Dextrocardia in adults with congenital heart disease. Situs solitus with dextrocardia in situs solitus with a right thoracic heart, the lungs and abdominal viscera are normally positioned, the ascending aorta and aortic knuckle are normally located, the descending aorta runs its normal course along the left side of the vertebral column, but the major cardiac shadow lies to the right of midline. Background dextrocardia is an abnormal congenital positioning of the heart. Dextrocardia can be defined as a heart in the right chest with the major axis to the right. In mesocardia, the heart is centrally located in the chest with normal atrial and visceral anatomy. Definition the cardiac apex is located in the right side of the chest three anatomic variations associated with dextrocardia are presented here situs inversus totalis mirror image dextrocardia dextroversion with situs solitus dextroposition of the heart. In brazil it spreads out in the amazon, atlantic solitis, southern fields and pantanal. Primary dextrocardia with situs solitus normal the dog it is not well characterized. The aim of this study was to report a case of dextrocardia with situs inversus totalis.
It was observed among between the animals studied figure 1 a and b a female with dextrocardia with situs solitusshown only an inverted heart, while the and other organs had normal topography. The majority of dextrocardia is associated with situs solitus and either normally related or ltransposed great vessels. Dextrocardia with situs solitus occurs in an estimated 750029 000 living people worldwide. This differs from previous series, which have reported situs inversus as being more common than situs solitus in those with dextrocardia. Tricuspid atresia with dextrotransposition, dextrocardia. Although dextrocardia can be associated with situs solitus, situs inversus or situs ambiguous, situs solitus is the most common form. Additionally, the position of the heart chambers as well as the visceral organs such as the liver and spleen is reversed situs inversus. Instead of the heart forming in the fetus on the left side, it flips over and forms on the right side 1 situs inversus also called situs transversus is a congenital condition in which the major visceral organs are reversed or mirrored from their normal positions.
Isolated dextrocardia with situs solitus dextroversion. In this type of dextrocardia, the tip of the heart and. Dextrocardia also occurs in association with all forms of congenitally corrected tga in up to 30% of cases. Sixtyfour per cent of our patients had situs solitus. Levocardia, dextrocardia and mesocardia are general terms indicating cardiac. There were twelve cases of dextrocardia in situs solitus. Dextrocardia definition of dextrocardia by the free dictionary. Some 20% of patients with dextrocardia with situs inversus display kartageners syndrome, which.
Dextrocardia and situs inversus in a dog veterinary world. Although there is a variation in terminology and classification with regard to dextrocardia, the condition of rightsided heart with situs solitus is most commonly referred to as dextroversion. Situs inversus with dextrocardia is the complete inversion of position of the thoracic and abdominal viscera. Avens publishing group dextrocardia with situs inversus. Situs inversus with dextrocardia is termed situs inversus totalis because the cardiac position, as well as abdominal viscera, is the mirror image of the normal anatomy. Additionally, the position of the heart chambers as well as the visceral organs such as the. The radiograph shows situs solitus, levocardia and. Situs solitus is the medical term referring to the normal position of thoracic and abdominal organs. It may be isolated or associated with malformations, especially cardiac or alimentary. When dextrocardia with situs solitus occurs, the ventricles are inverted but not the viscera and therefore not the atria.
We report a 69 year old nigerian woman found to have. Dextrocardia may adversely affect other thoracic organs. Rightsided organs are the liver, the gall bladder and a trilobed lung as well as. In people affected by dextrocardia, the tip of the heart points towards the right side of the chest instead of the left side. Other forms of dextrocardia that may be discovered in adults are situs solitus with dloop ventricles and normally related great arteries a variant of dextroversion, situs solitus with lloop ventricles and ltga congenitally corrected tga, situs inversus with dloop ventricles and dtga congenitally corrected tga, and dextrocardia. It is a rare clinical phenomenon with a reported incidence of 1 in 5,00030,000. Situs ambiguous is not characterized by a single set of abnormalities but by a spectrum of abnormalities. We describe a case of cctga, dextrocardia, and situs inversus in the oldest patient diagnosed with these congenital abnormalities to date. Of 40 patients satisfying this definition in the files of the brompton hospital, 33 had angiocardiographic data adequate.
Although cardiac problems are more common than in the general population, most people with situs. Dextrocardia with situs solitus dextroversion corresponds to isolated malposition of the heart and other organs in normal position 46. Dextrocardia with situs inversus is rare and presents in different forms depending on the atrioventricular av and ventricularaterial va relationship. The arrangements of the position of the abdominal viscera in dextrocardia may be normal situs solitus, reversed situs inversus, and indeterminate situs ambiguous or isomerism in 32 to 35%, 35 to 39% and 26 to 28% of cases respectively. Heterotaxie, isomerisme, polysplenie, asplenie, situs ambigus, situs inversus, situs solitus. Dextroversion is the rarest form of dextrocardia, and occurs along with typically serious cardiac abnormalities. In contrast, situs inversus with levocardia is an extremely rare variant that is characterized by mirrorimage location of the viscera relative to. Dec 12, 2008 situs inversus totalis or situs inversus with dextrocardia indicates mirrorimage location of the heart and viscera relative to situs solitus.
In one study, situs solitus was associated with chd in 93% of the cases, with left to right shunts being the most common 40. Mitral valve replacement in dextrocardia with situs. In contrast to individuals with situs solitus or situs inversus with dextrocardia, those with situs ambiguous have congenital heart disease in 50%100% of cases 3,21. In a very special form of situs ambiguus known as dextrocardia, all the organs are in the correct place except for the heart, which is moved to the right side of the chest. The normal arrangement of internal organs is known as situs solitus while situs inversus is generally the mirror image of situs solitus. Dextrocardia can also occur in a condition called situs inversus. Situs solitus was the most common type in our study 47%, which is in contrast to the study of walmsley et al, in which situs solitus was least frequent 22%. Abdominal manifestations of situs anomalies in adults. Dextrocardia may also occur with normal visceroatrial relationships situs solitus. Dextrocardia with situs inversus and associated cardiac malformation free download as powerpoint presentation. Pdf anatomy of a dextrocardia case with situs solitus. One slight difference is that right lung is smaller than the left lung, in order to accommodate the heart. The full text of this article is available in pdf format.