What is the difference between dextrocardia and dextroposition? Cardiology Basics

What is the difference between dextrocardia and dextroposition? Cardiology Basics

Dextrocardia means heart is situated in the right hemithorax instead of the left, as a congenital anomaly. In dextroposition, the heart is either pushed to the right or pulled to the right by another abnormality, usually in the lungs. Heart can be pulled to the right when the right lung is collapsed due to some reason, leaving more space on the right side of the chest. Here we have two X-rays illustrating dextrocardia and dextroposition. First one is true dextrocardia while the second is dextroposition due to large pleural effusion on the left side.

In the first one, along with the heart, other viscera have also switched position, that is a total situs inversus. Here stomach air bubble is seen on the right side and the liver shadow on the left side. Location of stomach is usually identified on X-ray by the presence of air in it, often forming a horizontal air-fluid level if there is fluid in the stomach. This type of dextrocardia is also known as mirror-image dextrocardia as it appears as if viewing in a mirror. The ascending aortic shadow has been marked on the left side. Crowding of upper ribs on the right side could be due to the associated mild scoliosis.

In this chest X-ray, there is massive pleural effusion on the left side pushing the heart to right side producing a dextroposition. The liver shadow is on the right side indicating that there is no situs inversus. Stomach air bubble is not visible well in this X-ray. The higher level of pleural effusion towards the axilla is visible.