A retrospective review of right-sided hearts at a South African tertiary hospital

Cardiovasc J Afr. 2019;30(1):5-8. doi: 10.5830/CVJA-2018-051. Epub 2018 Nov 21.

Abstract

Background: A right-sided heart (RSH) has three main causes: dextrocardia, dextroposition and dextroversion. It may be associated with cardiac malformation, extra-cardiac abnormalities and adverse patient outcomes. The aim of this study was to determine the prevalence, demographics, associated cardiac malformations (ACM) and outcome of paediatric patients diagnosed with a RSH at a South African tertiary hospital.

Methods: A retrospective review was performed over a 22-year period.

Results: RSH comprised 1% of the paediatric cardiology referrals. Dextrocardia was the most frequent cause (58.1%) and the majority of these patients had ACM (81.5%). More than a third (40.9%) were diagnosed with dextroposition, secondary to extra-cardiac factors. Dextroversion was the least common cause (1.1%). Over a quarter of all patients were confirmed dead at the time of the study; most had been diagnosed with dextrocardia. Two-thirds of the patients were lost to follow up.

Conclusions: A RSH is an unusual occurrence. Dextrocardia, the most common cause, is frequently associated with ACM and extra-cardiac abnormalities. It is therefore important to timeously elucidate the cause of a RSH.

Keywords: dextrocardia; dextroposition; dextroversion; right‐sided hearts.

MeSH terms

  • Adolescent
  • Cause of Death
  • Child
  • Child, Preschool
  • Dextrocardia* / diagnostic imaging
  • Dextrocardia* / mortality
  • Dextrocardia* / physiopathology
  • Dextrocardia* / surgery
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Pregnancy
  • Prenatal Diagnosis
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • South Africa / epidemiology
  • Tertiary Care Centers*