Advertisement

The Cardiac Position and Axis Orientation

Abstract

Although in most individuals two thirds of the heart is in the left side of the chest, the heart can be unusually positioned. All cardiac positions can be described in terms of overall location of the heart and orientation of its axis. The cardiac position and ax-is can be assessed by fetal echocardiography in the four-chamber view. In this view, by tracing the sagittal and coronal planes through the center of the thorax, four quadrants are identified. In the normal individual, the left ventricle, most of the right ventricle, and the anterior part of the left atrium, lie in the left anterior quadrant. A small part of the right ventricle and most of the right atrium fall in the right anterior quadrant, and the posterior part of the left atrium is in in the posterior quadrants (Fig.4.1) [1].
Fig. 4.1

Cross-sectional four-chamber view of a normal 21-week gestational-age fetus. The four quadrants, identified by the sagittal and coronal planes (white dashed lines) traced in the center of the thorax, are shown (see text for details.) LA left atrium, LV left ventricle, RA right atrium, RV right ventricle, S spine

Keywords

Axis Orientation Situs Inversus Yellow Arrow Pulmonary Valve Stenosis Cardiac Axis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Schmidt KG, Silverman NH (1988) Evaluation of the fetal heart by ultrasound. In: Callen PW. Ultrasonography in obstetrics and gynecology. WB Saunders, pp 165–206Google Scholar
  2. 2.
    Comstock CH (1987) Normal fetal heart axis and position. Obstet Gynecol 70:255–259PubMedGoogle Scholar
  3. 3.
    Shipp TD, Bromely B, Hornberg LK et al (1995) Levorotation of the fetal cardiac axis: a clue for the presence of congenital heart disease. Obstet Gynecol 85:97–102CrossRefPubMedGoogle Scholar
  4. 4.
    Smith RS, Comstock CH, Kirk JS et al (1995) Ultrasonographic left cardiac axis deviation: a marker for fetal anomalies. Obstet Gynecol 85:187–191CrossRefPubMedGoogle Scholar
  5. 5.
    Bromley B, Benacerraf BR (1997) Unilateral lung hypoplasia. Report of three cases. J Ultrasound Med 16:599–601PubMedGoogle Scholar
  6. 6.
    Stanger P, Rudolph AM, Edwards JE (1977) Cardiac malpositions: an overview based on study of sixty-five necropsy specimens. Circulation 56:159–172PubMedGoogle Scholar
  7. 7.
    Lev M, Liberthson RR, Golden JG et al (1971) The pathologic anatomy of mesocardia. Am J Cardiol 28:428–435CrossRefPubMedGoogle Scholar
  8. 8.
    Rosado-de-Christenson ML, Stocker JT (1991) Congenital cystic adenomatoid malformation. Radio-Graphics 11:865–886Google Scholar
  9. 9.
    Bromley B, Parad R, Estroff JA et al (1995) Fetal lung masses: prenatal course and outcome. J Ultrasound Med 14:927–936PubMedGoogle Scholar
  10. 10.
    Walmsley R, Hishitani T, Sandor GG et al (2004) Diagnosis and outcome of dextrocardia diagnosed in the fetus. Am J Cardiol 94:141–143CrossRefPubMedGoogle Scholar
  11. 11.
    A Bernasconi, A Azancot, JM Simpson et al (2005) Fetal dextrocardia: diagnosis and outcome in two tertiary centres. Heart 91:1590–1594CrossRefPubMedGoogle Scholar
  12. 12.
    Ortiga DJ, Chiba Y, Kanai H et al (2001) Antenatal diagnosis of mirror-image dextrocardia in association with situs inversus and Turner’s mosaicism. J Matern Fetal Med 10:357–359CrossRefPubMedGoogle Scholar
  13. 13.
    Pauliks LB, Friedman DM, Flynn PA (2000) Fetal, diagnosis of atrioventricular septal defect with dextrocardia in trisomy 18. J Perinat Med 28:412–413CrossRefPubMedGoogle Scholar
  14. 14.
    Allan LD, Irish MS, Glick PL (1996) The fetal heart in diaphragmatic hernia. Clin Perinatol 23:795–811PubMedGoogle Scholar
  15. 15.
    Sharland GK, Lockhart SM, Heward AJ et al (1992) Prognosis in fetal diaphragmatic hernia. Am J Obstet Gynecol 166:9–13PubMedGoogle Scholar
  16. 16.
    Winer-Muram HT, Tonkin ILD (1989) The spectrum of heterotaxic syndromes. Radiol Clin North Am 27:1147–1170PubMedGoogle Scholar
  17. 17.
    Hagler DJ, O’Leary PW (1995) Cardiac malpositions and abnormalities of atrial and visceral situs. In: Emmanouilides GC, Riemenschneider TA, Allen HD et al (eds) Heart disease in infants, children and adolescents including the fetus and young adult. Williams & Wilkins, Baltimore, pp 249–294Google Scholar
  18. 18.
    Calcaterra G, Anderson RH, Lau KC et al (1979) Dextrocardia: value of segmental analysis in its categorisation. Br Heart J 42:497–507CrossRefPubMedGoogle Scholar
  19. 19.
    Sharland G, Cook A (2000) Heterotaxy syndromes/isomerism of the atrial appendages. In: Allan LD, Hornberg L, Sharland GK (eds) Textbook of fetal cardiology. Greenwich Medical Media, London, pp 335–346Google Scholar

Copyright information

© Springer-Verlag Italia 2008

Personalised recommendations