Analysis of clinical characteristics of 38 patients with dextrocardia: An observational study

Dextrocardia is an extremely rare congenital anomaly, and survival into adulthood is exceptionally uncommon. This study aimed to systematically analyze the clinical, imaging, laboratory, and functional characteristics of patients with Dextrocardia to improve understanding of its natural history and prognosis. A retrospective review of 38 patients diagnosed with Dextrocardia at a single center from 2012 to 2025 was conducted. Baseline demographic data, associated anomalies, laboratory parameters, imaging findings, cardiac function assessed by the New York Heart Association (NYHA) classification, and follow-up outcomes were collected and analyzed. Of 38 patients, 21 (55%) were male and 17 (45%) were female; the majority were over 61 years of age (36.8%). All patients had Dextrocardia with the heart located entirely within the right hemithorax and no pericardial defects. Laboratory tests showed mild myocardial stress but preserved systemic homeostasis. Imaging demonstrated that computed tomography (CT) was the predominant diagnostic tool, providing detailed anatomical information, while chest X-radiation (X-ray) and echocardiography served as supplementary modalities. Most patients had preserved or mildly impaired cardiac function, around NYHA Class I-II. During a mean follow-up of 21.9 months, all patients survived without mortality. Dextrocardia without major anomalies may represent a distinct subtype with favorable outcomes. Chest CT is the most valuable imaging modality, and functional assessment is essential for prognosis. These findings broaden the clinical spectrum of Dextrocardia and challenge the traditional view that survival is universally poor.