ECG education

Dextrocardia and situs inversus

Vivienne Miller



An 18-year-old man with dextrocardia and situs inversus has an ECG performed to reassure him his reflux symptoms are not a heart attack. What does his ECG show?

Key Points

  • Mirror-image dextrocardia is the most common form of dextrocardia and occurs with situs inversus.
  • Dextroposition is where dextrocardia occurs because of a physical shift of the heart to the right due to mechanical factors.
  • Dextroversion is the rarest form of dextrocardia, and occurs along with typically serious cardiac abnormalities.
  • Isolated mirror-image dextrocardia without situs inversus is extremely rare.
  • Heterotaxy (situs ambiguus) is the malformation of the chest and abdominal organs found in conjunction with dextrocardia and situs inversus.
  • Noncardiac clinical signs of cyanotic congenital heart disease in adults include tachycardia, tachypnoea, cyanosis, fatigue and dyspnoea on minimal exertion, peripheral oedema from congestive cardiac failure, hypotension, poor peripheral pulses and clubbing of the digits.
  • Noncardiac clinical signs of cyanotic congenital heart disease in babies also include failure to thrive, aspiration and poor feeding, irritability and developmental delay.
  • Kartagener’s syndrome is a clustering of situs inversus, chronic sinusitis, immotile sperm and bronchiectasis.