Dextrocardia 2018-01-30T16:37:47+00:00

Relevant physical signs

  • Peripheries
    • No stigmata of infective endocarditis
    • Regular pulse
    • No clubbing / cyanosis
    • No conjunctival pallor
    • Jugular venous pulsation not raised
  • Precordium
    • Apex beat palpable on the right side
    • Heart sounds louder on the right than on the left
    • Listen carefully for any other added sounds
  • Lungs
    • Coarse crepitations of bronchiectasis (Kartagener’s syndrome)
      • Primary ciliary dyskinesia (autosomal recessive) resulting in bronchiectasis
      • Associated with situs inversus, bronchiectasis and sinusitis
  • Offer to examine abdomen for situs inversus

Investigations

  • Chest radiograph to look for dextrocardia
  • Electrocardiogram
    • Inverted P waves and QRS complexes in lead I
    • Reverse R wave progression – tallest in V1 and smaller towards V6
    • Normal ECG with right-sided chest leads

Management

  • No specific management necessary for isolated dextrocardia
  • Kartagener’s syndrome: see bronchiectasis

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