Cardiovascular Imaging

Malposition, cardiac

abnormal position of the heart in the thorax due to abnormal rotation of the embryonic heart. Instead of the cardiac apex being located in the left side of the thorax, it is located in the midline mesocardia, or in the right side of the thorax dextrocardia. Levocardia is a left-sided apex in the presence of situs inversus (Fig.1). Mirror image dextrocardia is a right-sided cardiac apex in the presence of situs inversus. Isolated dextrocardia is a right-sided apex in the presence of situs solitus or situs ambiguus. Complex congenital heart disease and splenic syndromes occur with isolated dextrocardia and levocardia. Dextroposition is the heart on the right side due to shift in position caused by a hypoplastic lung or some other abnormality of the thorax. Plain radiograph displays the cardiac apex on the right while the aortic arch and gastric bubble are on the left in isolated dextrocardia. It shows the cardiac apex, arch, and gastric bubble on the right in mirror-image dextrocardia. Symmetry of the two lungs may be recognized in the presence of splenic syndromes. Echocardiography, CT, and MRI can usually confirm the malposition in relation to the visceral situs. CT and MRI are the optimal techniques for defining arrangement of the abdominal viscera and the presence of asplenia or polysplenia. Echocardiography and MRI can identify the type of bulboventricular loops.

CBH

To view high resolution images,
please register first.

Click  here to register.

Already registered? Enter your e-mail in the window below.
Re-register

Fig.1

Chest radiograph shows aortic arch and air containing stomach (S) on the right with cardiac apex on the left. This constitutes levocardia.
Malposition, cardiac, Fig.1