Dextrocardia pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]
Overview
The exact pathogenesis of dextrocardia is not fully understood. The malposition is not as a result of any extracardiac abnormalities but intrinsic to the heart. It is as a result of embryological abnormalities that occur during the development of the heart. Genes involved in the pathogenesis of dextrocardia include: ZIC3, ACVR2B, NODAL.
Pathophysiology
Pathogenesis
- It may be caused by an abnormality in the cardiac formation, after the heart tube has been formed;
- After its formation, there is the looping of the heart tube which will determine the position of the ventricle and the atria.[1]
- If it loops to the right (D-loop), the right ventricle is located to the right of the left ventricle.
- If it loops to the left (L-loop), the right ventricle is located to the left of the left ventricle.
- Another possibility is a normal D-looped heart failing to migrate to the left hemithorax, which may cause a normal heart located in the right hemithorax. If an L-looped heart completes rotation in the right hemithorax, it can become situated in the right hemithorax.
- It may be associated with defect in dynein or cilia.[1]
Genetics
- It may be associated with a genetic condition called primary ciliary dyskinesia, which affects genes DNAI1 and DNAH5;[2]
- Other genes that may be involved in the pathogenesis of dextrocardia include: ZIC3, ACVR2B, NODAL.[3]
- In many instances other genetic causes are unknown.
Associated Conditions
Conditions associated with dextrocardia include:[4][5][6][7]
- Tricuspid atresia
- Transposition of the great vessels
- Pulmonary stenosis
- Double-outlet double-inlet ventricle
- Single ventricle
- Sick sinus syndrome
- Situs inversus
- Situs solitus
- Situs ambiguous
- Kartagener syndrome
- Double-outlet or double-inlet ventricles
References
- ↑ 1.0 1.1 "StatPearls". 2021. PMID 32310534 Check
|pmid=value (help). - ↑ Escudier E, Duquesnoy P, Papon JF, Amselem S (2009). "Ciliary defects and genetics of primary ciliary dyskinesia". Paediatr Respir Rev. 10 (2): 51–4. doi:10.1016/j.prrv.2009.02.001. PMID 19410201.
- ↑ Ma L, Selamet Tierney ES, Lee T, Lanzano P, Chung WK (2012). "Mutations in ZIC3 and ACVR2B are a common cause of heterotaxy and associated cardiovascular anomalies". Cardiol Young. 22 (2): 194–201. doi:10.1017/S1047951111001181. PMC 3678527. PMID 21864452.
- ↑ Khoury M, Harbieh B, Heriopian A (2013). "Isolated dextrocardia and congenital heart blocking". Radiol Case Rep. 8 (1): 521. doi:10.2484/rcr.v8i1.521. PMC 4900208. PMID 27330607.
- ↑ Panneerselvam A, Subbiahnadar P (2012). "Is it dextrocardia or dextroversion?". BMJ Case Rep. 2012. doi:10.1136/bcr.01.2012.5493. PMC 3316784. PMID 22605582.
- ↑ Ogunlade O, Ayoka AO, Akomolafe RO, Akinsomisoye OS, Irinoye AI, Ajao A; et al. (2015). "The role of electrocardiogram in the diagnosis of dextrocardia with mirror image atrial arrangement and ventricular position in a young adult Nigerian in Ile-Ife: a case report". J Med Case Rep. 9: 222. doi:10.1186/s13256-015-0695-4. PMC 4584464. PMID 26411880.
- ↑ Maldjian, Pierre D.; Saric, Muhamed (2007). "Approach to Dextrocardia in Adults:Review". American Journal of Roentgenology. 188 (6_supplement): S39–S49. doi:10.2214/AJR.06.1179. ISSN 0361-803X.