Dextrocardia

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Dextrocardia Classification and external resources
ICD-10	Q24.0
ICD-9	746.87
DiseasesDB	3617
MeSH	C14.240.400.280

Dextrocardia refers to the heart being situated on the right side of the body. Dextrocardia Situs Inversus refers to the heart being a mirror image situated on the right side. For all visceral organs to be mirrored, the correct term is Dextrocardia Situs Inversus Totalis.

Dextrocardia is believed^{[citation needed]} to occur in approximately 1 in 8000 people, while 1 in 1,000 of these will have Situs Inversus. Totalis occurs in approximately 1 in 5,000 of Dextrocardia Situs Inversus.

Kartagener’s Syndrome occurs in approximately 1 in 25 of Totalis. This disorder affects the sinus and bronchial cilia causing constant sinus and bronchial symptoms that medication can not rectify. With Kartagener’s both are usually present all year rather than being seasonal.

Although statistically people with Dextrocardia Situs Inversus do not have any medical problems from the disorder, some are prone to a number of bowel, esophagus, bronchial and cardiac problems. Some of these conditions can be life threatening if left unchecked.

ECG leads must be placed in reversed positions on a person with Dextrocardia. In addition, when defibrillating someone with dextrocardia, the pads should be placed in reverse positions. That is, instead of upper right and lower left, pads should be placed upper left and lower right.

"Technical dextrocardia" refers to the apparent presentation of dextrocardia caused usually by inadvertantly swapping the limb leads on a 12 lead ECG. Usually this would show as an extreme axis deviation.

[edit] Use as a plot device

• Fortune, a character from Metal Gear Solid 2: Sons of Liberty has dextrocardia. The condition prolongs her death when she is shot on the wrong side.

• Julius No (Dr. No) from 007 James Bond also had dextrocardia. He survived being "shot in the heart and left for dead".

• A shooting victim in the CSI: Crime Scene Investigation episode "Bully for You" was nearly killed 6 months prior to the episode because he was stabbed by a fork to the left of the sternum, where his heart should have been normally. Of the 3 .44 caliber bullets that struck the victim, the show's medical examiner confirmed a cardiac wounding on the right side of the chest. Additional dialogue indicated all of his organs were mirrored, as in situs inversus totalis, but the only descriptive term used is "dextrocardia" (with no modifiers).

[edit] References

• MedEd at Loyola GrossAnatomy/thorax0/Heart_Development/Dextrocardia.html
• Overview at rch.org.au

v • d • e Congenital malformations and deformations of circulatory system (Q20-Q28, 745-747) Cardiac chambers and connections Persistent truncus arteriosus - Double outlet right ventricle (Taussig-Bing syndrome) - Transposition of the great vessels (dextro, levo) Cardiac septa Ventricular septal defect - Atrial septal defect (Lutembacher's syndrome) - Atrioventricular septal defect (Ostium primum) - Tetralogy of Fallot - Eisenmenger's syndrome Valvular heart disease/ heart chambers Right: pulmonary and tricuspid valves pulmonary valves (stenosis, insufficiency) - tricuspid valves (stenosis, atresia) - Ebstein's anomaly Left: aortic and mitral valves aortic valves (stenosis, insufficiency, bicuspid) - mitral valves (stenosis, regurgitation) - Hypoplastic left heart syndrome Other congenital malformations of heart Dextrocardia - Levocardia - Cor triatriatum Vascular malformation Great arteries aorta: Patent ductus arteriosus - Aortic coarctation - Interrupted aortic arch - Overriding aorta - Aneurysm of sinus of Valsalva - Vascular ring pulmonary artery: Pulmonary atresia Great veins superior vena cava: Persistent left superior vena cava pulmonary vein: Total anomalous pulmonary venous connection - Scimitar syndrome Other Arteriovenous malformation (Cerebral arteriovenous malformation) See also non-congenital conditions (I, 390-459)