ARBA MINCH UNIVERSITY

COLLEGE OF MEDICINE AND HEALTH SCIENCE

DEPARTMENT OF NURSING
POST GRADUATE IN MATERNITY AND RH NURSING
By: Markos Makisha
ID: PRMHS/045/13

Dextrocardia

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 objectives

At the end of these lesson you will be able to:-

• Define dextrocardia
• List types of dextrocardia
• Explain diagnosis and management of
dextrocardia

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 outline

• Defnition
• Anatomical difference
• Incidence
• Risk
• Cause
• Diagnosis
• Management
• Complication
• Prognosis
• Nursing intervention
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 Definition

• Dextrocardia is a rare heart condition in which your

heart points toward the right side of your chest
instead of the left side.
• Dextrocardia is a congenital condition.
• The condition is usually not life-threatening, although
it often occurs alongside more serious complications,
such as heart defects and organ disorders in the
abdomen.

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 ANATOMICAL DIFFERENCE

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 Incidence

• Less than 1 percent of the general population is born

with dextrocardia.
• Dextrocardia affects an estimated1 out of every
12,000 people trusted source 
• Gender, race, and ethnicity do not seem to have any
impact on whether or not a person develops the
condition.

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 Who is at highest risk

 families with a history of genetic problems

 congenital heart disease
 mothers who consume alcohol

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 Cause

• Non-dominant (also called autosomal recessive)

genes cause dextrocardia.
• These abnormal genes cause the primitive, or cardiac,
tube to reverse direction while a fetus is developing
in the womb.

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 Cont..

• Depending on the extent and timing of the reversal,

the heart and abdominal organs may also develop in a
reversed form.
• As it is recessive genes that cause dextrocardia, an
individual must inherit a copy of the abnormal gene
from both parents to develop the condition.

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 Classification

There are two major types of dextrocardia.

• Dextrocardia situs inversus
• Dextrocardia with situs inversus totalis

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 Cont…

1. Dextrocardia situs inversus

In this type of dextrocardia, the tip of the heart and its
four chambers are pointing towards the right side of
the body.

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 Cont..

2. Dextrocardia with situs inversus totalis

• With this type of dextrocardia, abdominal and chest
organs and other vessels, such as:-
 the liver
 stomach, and spleen are also out of position.
• In fact, the other organs are in the opposite position,
or in mirror-image reversal, to where they should be.

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 Physical exam

• Apex beat is 5th left intercostal space in the mid

clavicular line.
• S1 can be best hear on the apex, 5 th left inter costal
space.
• S2 can be heard on left sternal notch DEXTRO
CARDIA
• Apex beat is on the right side
• Abdominal organs are seen in other quadrant

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 Signs and symptoms of dextrocardia

If coupled with other conditions or complications,

symptoms can include:
• Bluish skin or lips from lack of oxygen
• Breathing difficulties
• Failure to grow
• Fatigue
• Holes in the septum
• Jaundice (yellowing of skin)
• Lung infections
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 Cont…

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

Conditions that can include dextrocardia may cause
the following signs:
• Abnormal arrangement and structure of the organs in
the abdomen
• Enlarged heart
• Rapid breathing or problems breathing
• Rapid pulse

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 Diagnosis

• Most cases of dextrocardia are diagnosed using an

electrocardiogram (EKG) and chest X-ray.
• An EKG that shows inverted or reversed electrical
waves usually points to dextrocardia.
• Once a doctor suspects dextrocardia, they may use a
computed tomography (CT) scan
• magnetic resonance imaging (MRI) scan to confirm
the condition.

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 Management

 Treatment for conditions that include dextrocardia

depends on whether the infant has other heart or
physical problems in addition to dextrocardia. 
 The baby might also need surgery to correct problems
in the organs of the abdomen.
 May need long-term antibiotics in case of recurrent
infections. Patient picture

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 Cont..

• If heart defects are present with dextrocardia, the

baby will most likely need surgery.
• Critically ill babies may need treatment with
medication before surgery.

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 Cont…

These medications help the baby grow larger so surgery

is less difficult to perform. Medications include:
• Water pills" (diuretics)
• Medications that help the heart muscle pump more
forcefully (inotropic agents)
• Medications that lower blood pressure and ease the
workload on the heart (ACE inhibitors)

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 Prognosis

• Babies with simple dextrocardia have a normal life

expectancy and should have no problems related to
dextrocardia.
• Dextrocardia with other defects in the heart prognosis
can be poor.
• The death rate in babies and children without a spleen
may be high due to infections.

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 Prevention

there are no known ways to prevent dextrocardia, can be

prevent
• avoiding the use of illegal drugs (especially cocaine)
before and during pregnancy may lower the risk of
this problem.
• Talk to your health care provider if you have diabetes,
because it may contribute to your risk of having a
child with certain forms of dextrocardia.

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 Complication

Complications depend on whether dextrocardia is part

of a larger syndrome, and whether other problems
exist in the body.
Complications include:
• Bacteria in the blood (septic shock)
• Blocked intestines (due to a condition called
intestinal mal rotation)
• Congestive heart failure

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 Cont…

• Death
• Infection (hetero taxy with no spleen)
• Infertility in males (Kartagener syndrome)
• Repeated pneumonias
• Repeated sinus infections (Kartagener syndrome)

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 Nursing care

Head to toe P/E

•Frequent vital signs
•Timely evaluate cyanosis ,Oxygen therapy and its
adjustment
•Medication administration
•Feeding and educating mother how to feed
•Prepare for surgery ,pre and post operative care
•Sterile wound care
•Health education of mothers and care givers
•Monitor input and out put
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 Cont…

• Thermoregulation
•Kangaroo mother care
•Fluid and electrolyte preparation and monitoring.
•NGT,IV line insertion and frequent follow –up
•Monitoring blood glucose level
•Phototherapy ,incubator and radiant heater monitoring
and adjustment
•Wait measurement and frequent positioning
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 Reference

1. Lewis medical surgicalnursing.Elsevier;2011.P 634-

663.
2. Wongs essential of pediatric nursing. 7 ed.
3. Lippincott manual of nursing practice. 10 ed.
4. Clinical respiratory journal published in 2016.
5. Medline plus medical encyclopedia [internet]

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