Presentation
Chest pain. Unknown congenital cardiac history. History of dextrocardia, and behavioral issues.
Patient Data
The cardiac apex is on the right, the aortic arch is on the left, and the gastric fundic gas bubble is on the left consistent with dextrocardia.
Mild diffuse cardiomegaly considering technique and mild rotation to the right without significant central pulmonary vascular congestion.
No discrete focal pneumonia, effusion or pneumothorax. The left mid and lower lung zones are emphysematous.
The left upper four ribs are hypoplastic compared to the right, likely congenital/developmental.
No acute displaced fracture. Slightly elevated left hemidiaphragm. No free air in the upper abdomen.
Case Discussion
Dextrocardia is when the heart rests on the right side of the chest. It is often associated with other congenital abnormalities, in this case, hypoplastic left upper ribs. In 0.01% of live births, a child is born with dextrocardia. Furthermore, dextrocardia is often diagnosed incidentally.
This case was submitted with supervision and input from:
Soni C. Chawla, M.D.
Health Sciences Clinical Professor,
Department of Radiological Sciences,
David Geffen School of Medicine at UCLA.
Attending Pediatric Radiologist,
Olive View - UCLA Medical Center.
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