K.Levo-TGA, Detrocardia, DORV
(See Normal Heart Image for comparison)
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- Dextrocardia [dextro=on the right side]-the heart is reversed and in the right side of the chest (instead of the left). The lower tip of the heart also points to the right (instead of the left).
- Double Outlet Right Ventricle (DORV) [outlet=passage for exit, ventricles=lower chambers of the heart] – both vessels (aorta & pulmonary artery) carrying blood away from the heart come out of the right ventricle. (Normally the aorta carries oxygen-rich blood from the left ventricle and the pulmonary artery carries oxygen-poor blood from the right ventricle).
- Pulmonary Stenosis (PS) [pulmonary=having to do with the lungs, stenosis=narrowing of a passage, ] – a narrowing of the pulmonary artery (which carries blood from the heart to the lungs) at or near the pulmonary valve.
- Infracardiac Total Anomalous Pulmonary Vein Return (TAPVR) [infra=below, cardiac=of the heart, anomalous=not normal, pulmonary=having to do with the lungs, vein=blood vessel, return=come back] – a structural defect where the pulmonary veins (which normally carry oxygen-rich blood from the lungs back to the left atrium of the heart) do not connect to the left atrium at all. Instead, the pulmonary veins connect to the Hepatic Vein (which brings oxygen-depleted blood from the liver back to the right atrium of the heart). An ASD is the only source of blood for the left side of the heart (which normally supplies oxygen-rich blood to the body). This causes oxygen-rich and oxygen-depleted blood to mix before being pumped out to the body. TAPVR often presents with pulmonary vein stenosis.
- levo-Transposition of the Great Arteries (TGA) (“congenitally corrected TGA”)[levo=left, transposition=switch the order, great arteries=the aorta & the pulmonary artery] – the ventricles (lower chambers of the heart) and attached valves (mitral and tricuspid valve) are switched–so the left ventricle is attached to both the aorta and the right artery (via the tricuspid valve) while the right ventricle is attached to the pulmonary artery and the left artery (via the tricuspid valve). Because the ventricles are switched, the great arteries (aorta, pulmonary artery) are attached the the wrong “pumps.”
- Isolated Atrioventricular Discordance [atrioventricular=having to do with the atrium and ventricle, discord=lack of agreement] The atriums are connected to the wrong ventricles. So in this heart (with the dextrocardia):
- the LEFT ATRIUM is on the patient’s right side [right-sided left atrium: r-LA]. The RIGHT VENTRICLE is directly below it on the patient’s right side [right-sided right ventricle: r-RV]. (In a normal heart the LEFT ventricle is below the left atrium.)
- the RIGHT Atrium is on the patient’s left side [left-sided right atrium: l-RA]. The LEFT VENTRICLE is directly below it on the patient’s left side [left-sided left left ventricle: l-LV]. (In a normal heart, the RIGHT ventricle is below the RIGHT atrium.
- Interrupted Inferior Vena Cava [interrupted=a break, inferior=lower, vena=vein, cava=space] The main vein from the lower half of the body doesn’t lead into the heart as it should. Instead it follows a unique path where the oxygen-depleted blood ends up in the right atrium via another path:
- Asygos continuation- [The Azygos vein travels behind the heart near the spine. It connects the upper and lower Vena Cava outside of the heart and sometimes acts as an alternate route for oxygen-depleted blood when the normal path is closed.] In this heart, it connects at the…
- right branch of the Superior Vena Cava [superior=higher, vena=vein, cava=space] – the right-branch of the main vein from the upper half or the body leading into the heart that brings oxygen-depleted blood into the heart.
- Ventricular Septal Defect (VSD) [septum=wall between the chambers of the heart, ventricles=lower chambers of the heart] – holes in the inner walls of the heart allowing extra blood flow between the two lower chambers of the heart (ventricles). This causes the oxygen-rich and oxygen-poor blood to mix before leaving the heart.
Also (not pictured):
- Ventricular Arterial Concordance[ventricular=ventricles, arterial=blood vessels carrying oyxgen-rich blood, concord=agreement] : the blood vessels that nourish the ventricles of the heart are in the correct positions despite the ventricles within the heart being in the incorrect positions (from the levo-TGA). These blood vessels would be drawn on the outside surface of the heart, so they’ve been left off because we’re looking at the inside of the heart.
- Sick sinus node syndrome: This is a problem with the electrical pathways of the heart that is beyond the scope of this website. Look here for more information: http://www.hrsonline.org/patientinfo/heartrhythmdisorders/sss/index.cfm
- Complete heart block: This is a problem with the electrical pathways of the heart that is beyond the scope of this website. Look here for more information: http://www.hrsonline.org/PatientInfo/HeartRhythmDisorders/HeartBlock/index.cfm
- Heterotaxy [hetero=different, taxy=forming]:abnormal position of the organs inside the body. Look here for more information: http://chdbabies.blogspot.com/2009/08/overview-of-heterotaxy.html