Dextrorotation of the Heart

Cardiac dextrorotation: understanding and clinical implications

Introduction

Cardiac dextrorotation, also known as cortical dextrorotation, is a rare congenital anomaly that affects the position and orientation of the heart in the chest cavity. In this article, we will review the concept of cardiac dextrorotation, its causes, clinical significance, and possible treatment approaches.

Definition and reasons

Cardiac dextrorotation is a congenital condition in which the heart is rotated to the right relative to its normal position. Usually the heart is located to the left of the middle of the chest cavity, but during dextrorotation it moves to the right. This occurs due to the unusual development of embryonic heart structures in the early stages of pregnancy.

The causes of cardiac dextrorotation are not fully known. It may be associated with genetic factors or result from environmental influences on embryonic development. Some studies also indicate a possible link between cardiac dextrorotation and other congenital abnormalities, such as genetic syndromes or organ development disorders.

Clinical relevance

Cardiac dextrorotation can have varying clinical consequences depending on how severely the cardiac structures are affected. In some patients, cardiac dextrorotation may remain undetected and non-clinically significant throughout their lives. However, in others it can cause heart defects or lead to functional disorders of the cardiovascular system.

Symptoms and diagnosis

In patients with cardiac dextrorotation, symptoms can be varied and depend on the combination of this anomaly with other heart defects. Some common symptoms may include failure to thrive, shortness of breath, fatigue, abnormal heart rhythm, or cyanosis (blue color of the skin and mucous membranes).

Various examination methods are used to diagnose cardiac dextrorotation. This may include echocardiography, computed tomography (CT) or magnetic resonance imaging (MRI) of the heart. These methods allow the structures of the heart to be visualized and their position and orientation determined.

Treatment and prognosis

Treatment of cardiac dextrorotation depends on its clinical significance and associated heart defects. Patients without heart failure or major defects may not require active treatment. However, in some cases, surgery may be required to correct the abnormality or treat associated heart defects.

The prognosis for patients with cardiac dextrorotation depends on the severity of associated defects and the effectiveness of treatment. In most cases, with timely diagnosis and treatment, the prognosis is favorable. However, in some severe cases, especially those with serious heart defects, the prognosis may be less favorable.

Conclusion

Cardiac dextrorotation is a rare congenital anomaly that affects the position and orientation of the heart in the chest cavity. Understanding this anomaly and its clinical significance is important to ensure accurate diagnosis and optimal treatment. Cardiac dextrorotation requires an individualized approach to each patient, and treatment decisions should be based on symptoms, clinical significance, and associated cardiac defects. Modern methods of diagnosis and surgical treatment allow achieving good results in most patients, which helps improve their quality of life.

Dextrorotation is a congenital defect in which the arterial and venous circulation of the heart occurs in reverse. The left-right axis is incorrectly divided, resulting in dextroposition of the heart from the left half of the chest to the right side. This condition can be recognized on ultrasound of the heart; atrioventricular regurgitation and ductus-dependent pathological echo can also be noted. In such cases, there are often no symptoms and are usually only discovered by chance during the diagnosis of some other disease. However, dextroposition in some cases can manifest itself as critical symptoms and conditions leading to pathologies such as left-sided pulmonary embolism, myocardial ischemia or atonic death.

One of the main causes of such pathologies is atrioventricular regurgitation during distal atresia of the tricuspid valve. It has a complex hemodynamic form and is manifested by the expansion of the right atrium, which is located above the tricuspid valve. These abnormalities result in a pulmonary flow geometry where the return flow of blood flows directly into the aortopulmonary artery rather than into the aoa system, often leading to pulmonary disease or thromboembolic events. An additional danger with this condition is pulmonary vascular obstruction, which can cause lung collapse. Treatment associated with open heart surgery must ensure the presence of adequate pulmonary supply at the time of bypass surgery