Isolated dextrocardia

Case contribution: Dr Radhiana Hassan


  • A 66 years old man
  • Type 2 DM on insulin
  • Also had diabetic nephropathy and dyslipidaemia
  • Presented with diabetic foot
  • Planned for amputation
  • Pre-operative chest radiograph done
Chest radiograph frontal erect view
Abdominal radiograph AP erect view

Radiographic findings:

  • The heart shadow is seen projecting over the right side of the thoracic cavity
  • The heart apex is pointing to the right side
  • Otherwise the aortic arch is normally located
  • No lung changes
  • Left hemidiaphragm is higher on the left side
  • Both costophrenic angles are sharp
  • Air in gastric fundus is seen on the left side.

Diagnosis: Dextrocardia


  • Dextrocardia is a congenital condition in which the heart is situated on the right side of the body with the apex pointing to the right.
  • There are two main types of dextrocardia:
    • dextrocardia of embryonic arrest (also known as isolated dextrocardia) and
    • dextrocardia situs inversus (heart and visceral organs are mirrored on the right side)
  • Dextrocardia is believed to occur in approximately 1 in 12,000 people 2.

Progress of patient:

  • Ultrasound abdomen shows normal position of liver and spleen
  • No other abnormality of intra abdominal organ
  • Echocardiography shows no abnormality of the heart
  • Patient subsequently had BKA for diabetic foot with uneventful recovery
Foot radiograph shows soft tissue swelling with multiple air pockets within (white arrows). No osteomyelitic change is seen.
Author: radhianahassan