ABSTRACT
Fetal dextrocardia is a condition in which the major axis of the heart points to the right. The term dextrocardia describes only the position of the cardiac axis and conveys no information regarding chamber organization and structural anatomy of the heart. Dextrocardia should be distinguished from dextroposition, in which the heart is shifted into the right chest as a consequence of pathological states involving the diaphragm, lung, pleura, or other adjoining tissues. The appearance of a smaller right side in the fetal chest should raise the suspicion of hypoplasia of the right lung with anomalous pulmonary venous drainage as in Scimitar syndrome. Hyperechoic areas may be seen occupying all or part of the lung field, suggesting a high airway obstruction or congenital cystic adenomatoid malformation (CCAM). The presence of cystic spaces should also raise the possibility of pulmonary sequestration or the mixed type of CCAM.
