Situs ambiguus (term discouraged; known anatomic location)
Definitions
Situs
Position of cardiac atria and viscera relative to midline
Independent of cardiac apex position
Situs solitus
Normal position of cardiac atria and viscera
Situs inversus
Mirror image of normal position
Isomerism
Equal parts (bilateral left- or right-sidedness)
Heterotaxy
Abnormal arrangement of thoraco-abdominal organs across left-right axis
Cardiac position
Refers to global location of heart in chest
Left (levoposition), midline (mesoposition), right (dextroposition)
Levocardia and dextrocardia: Location of cardiac apex
Levoversion: Situs inversus with levocardia
Dextroversion: Situs solitus with dextrocardia
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Fluoroscopic Findings
Echocardiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Frescura C et al: Isomerism of the atrial appendages: morphology and terminology. Cardiovasc Pathol. 47:107205, 2020
Kiran VS et al: The spectrum of cardiac anomalies associated with heterotaxy: a single-center study of a large series based on computed tomography. Pediatr Cardiol. 41(7):1414-24, 2020
Ugas Charcape CF et al: Characterisation of computed tomography angiography findings in paediatric patients with heterotaxy. Pediatr Radiol. 49(9):1142-51, 2019
Yim D et al: Disharmonious patterns of heterotaxy and isomerism: how often are the classic patterns breached? Circ Cardiovasc Imaging. 11(2):e006917, 2018
Lapierre C et al: Cardiac CT and MRI of cardiac malformations: how to interpret them? Diagn Interv Imaging. 97(5):519-30, 2016
Loomba RS et al: Determining bronchial morphology for the purposes of segregating so-called heterotaxy. Cardiol Young. 26(4):725-37, 2016
Loomba RS et al: Isomerism or heterotaxy: which term leads to better understanding? Cardiol Young. 25(6):1037-43, 2015
Schallert EK et al: Describing congenital heart disease by using three-part segmental notation. Radiographics. 33(2):E33-46, 2013
Kim SJ: Heterotaxy syndrome. Korean Circ J. 41(5):227-32, 2011
Lapierre C et al: Segmental approach to imaging of congenital heart disease. Radiographics. 30(2):397-411, 2010
Maldjian PD et al: Approach to dextrocardia in adults: review. AJR Am J Roentgenol. 188(6 Suppl):S39-49; quiz S35-8, 2007
Garg N et al: Dextrocardia: an analysis of cardiac structures in 125 patients. Int J Cardiol. 88(2-3):143-55; discussion 55-6, 2003
Fulcher AS et al: Abdominal manifestations of situs anomalies in adults. Radiographics. 22(6):1439-56, 2002
Applegate KE et al: Situs revisited: imaging of the heterotaxy syndrome. Radiographics. 19(4):837-52; discussion 53-4, 1999
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Isomerism of atrial appendages
Situs ambiguus (term discouraged; known anatomic location)
Definitions
Situs
Position of cardiac atria and viscera relative to midline
Independent of cardiac apex position
Situs solitus
Normal position of cardiac atria and viscera
Situs inversus
Mirror image of normal position
Isomerism
Equal parts (bilateral left- or right-sidedness)
Heterotaxy
Abnormal arrangement of thoraco-abdominal organs across left-right axis
Cardiac position
Refers to global location of heart in chest
Left (levoposition), midline (mesoposition), right (dextroposition)
Levocardia and dextrocardia: Location of cardiac apex
Levoversion: Situs inversus with levocardia
Dextroversion: Situs solitus with dextrocardia
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Fluoroscopic Findings
Echocardiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Frescura C et al: Isomerism of the atrial appendages: morphology and terminology. Cardiovasc Pathol. 47:107205, 2020
Kiran VS et al: The spectrum of cardiac anomalies associated with heterotaxy: a single-center study of a large series based on computed tomography. Pediatr Cardiol. 41(7):1414-24, 2020
Ugas Charcape CF et al: Characterisation of computed tomography angiography findings in paediatric patients with heterotaxy. Pediatr Radiol. 49(9):1142-51, 2019
Yim D et al: Disharmonious patterns of heterotaxy and isomerism: how often are the classic patterns breached? Circ Cardiovasc Imaging. 11(2):e006917, 2018
Lapierre C et al: Cardiac CT and MRI of cardiac malformations: how to interpret them? Diagn Interv Imaging. 97(5):519-30, 2016
Loomba RS et al: Determining bronchial morphology for the purposes of segregating so-called heterotaxy. Cardiol Young. 26(4):725-37, 2016
Loomba RS et al: Isomerism or heterotaxy: which term leads to better understanding? Cardiol Young. 25(6):1037-43, 2015
Schallert EK et al: Describing congenital heart disease by using three-part segmental notation. Radiographics. 33(2):E33-46, 2013
Kim SJ: Heterotaxy syndrome. Korean Circ J. 41(5):227-32, 2011
Lapierre C et al: Segmental approach to imaging of congenital heart disease. Radiographics. 30(2):397-411, 2010
Maldjian PD et al: Approach to dextrocardia in adults: review. AJR Am J Roentgenol. 188(6 Suppl):S39-49; quiz S35-8, 2007
Garg N et al: Dextrocardia: an analysis of cardiac structures in 125 patients. Int J Cardiol. 88(2-3):143-55; discussion 55-6, 2003
Fulcher AS et al: Abdominal manifestations of situs anomalies in adults. Radiographics. 22(6):1439-56, 2002
Applegate KE et al: Situs revisited: imaging of the heterotaxy syndrome. Radiographics. 19(4):837-52; discussion 53-4, 1999
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