MALPOSITION OF THE HEART Definition Malposition is a non-specific term used to indicate an abnormal position of the heart within or outside

the thorax. It also refer to appropriateness of the position of the heart in the thorax in relation to the sites. Different Positions Levocardia Is a left -sided heart and is the normal position of the heart in individuals with situs solitus. Dextrocardia Is a right-sided heart and is the normal position for individuals with situs inversus. Mesocardia Is the midline position of the heart in the thorax Ectopia Cordis Is a classic cardiac malformation where the heart is outside the thorax. Morphology Situs Solitus Visceroatrial situs solitus is the usual pattern present in normal subjects.

On the right side of the body

major lobe of the liver the anatomic right atrium the inferior vena cava trilobed lung eparterial bronchus stomach

On the left side of the body

spleen descending aorta bilobed lung hyparterialbronchus

The heart is located on the left hemithorax. Cardiac malformation include dextrocardia and mesocardia Situs Inversus Is the mirror image of situs solitus. The characteristic position of the heart is in the right hemithorax (dextrocardia), but the cardiac mass may also be malposed in the left side. Situs Ambiguus Situs ambiguus or heterotaxia is defined as the random orientation of the different organs. Altered left-right asymetry (heterotaxia) is often (more than 90% of cases) accompanied by severe cardiac malformations consisting of dissarrangement of cardiac chambers, abnormal venous connections, and altered great arterial alignment. Frequently associated with mesocardia and dextrocardia. Subtypes:

asplenia syndrome with right isomerism of the atrial appendages.

spleen is absent (asplenia) atrial appendages, bronchi and lungs tend to be mirror images of each other show anatomic features of the right-sided structures (right isomerism) two or more splenic masses (polysplenia) are present along the greater curvature of the stomach in patients with heterotaxia it is possible to find the heart in the left(levocardia) or in the right (dextrocardia) hemithorax or in the intermediate position (mesocardia)

polysplenia syndrome with left isomerism of atrial appendages

CARDIAC MALPOSITION WITH SITUS SOLITUS DEXTROCARDIA Definition Dextrocardia is a condition in which the heart is pointed toward the right side of the chest instead of normally pointing to the left. It is present at birth (congenital). Etiology and Prevalence Marden-Walker syndrome: A rare genetic disorder characterized by blepharophimosis (small eyelids), joint contractures and fixed facial expression.2 Kartagener's syndrome: A rare genetic disorder characterized by enlarged bronchial tubes, sinusitis and cross positioning of body organs.3 Camptomelia Cumming type: A rare syndrome characterized by limb and multiple abdominal organ abnormalities. The disorder results in death before birth or soon after. Patients with these congenital conditions commonly lead healthy lives. There is about a 5%10% prevalence of congenital heart disease in people with dextrocardia situs inversus and a 95% occurrence in situs inversus with levocardia. This would significantly increase the risk of acute coronary syndrome in situs inversus patients with levocardia, meaning they are at a much higher risk for a life-threatening cardiac emergency.
Dextrocardia is believed to occur in approximately 1 in a 100 people, while 1 in 1,000 of these will have Situs Inversus. Kartageners syndrome occurs in approximately 1 in 15-25 of patients with Totalis (situs inversus with dextrocardia). Kartagener Syndrome (KS), is a rare autosomal recessive genetic disorder caused by a defect in the action of the tiny hairs (cilia) lining the respiratory tract. Specifically, it is a defect in a gene coding for left-right dynein (lrd), a key structural protein in cilia.[1]