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Dextrocardia and Tachypnea 11 day old infant
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Dextrocardia and Tachypnea 11 day old infant

My son was born 11 days ago at 38 weeks. Shortly after birth he started grunting and having fast, labored breathing. They took him to the NICU and did a chest xray. The chest xray showed dextrocardia but they told me that his lungs looked normal on the xray. They said that his breathing would get better it was just from transitioning. They made an appointment w/ a pediatric cardiologist. We went there and had an echo and he said that everything appeared fine for the heart but he did have dextrocardia of the heart. He then looked at the chest xray and said that it looked to him that the left lung was small with a possible diaphram hernia. Then he wanted to repeat some of the echo and checked the diaphram and it was moving and appeared normal. Then he looked at the pulmunary veins. The vein to the right was sized at 6.3 but the vein to the left was .22. He referred us to get a repeat chest xray and to a pediatric pulmunologist.

We went to the pulmunologist and he said he thinks the lung is smaller by the xray and that his ribs were closer together and there was something in the bottom of the left lung that kept it from growing and said it could be a diaphram hernia, double liver, etc. He also said to watch the repsiratory rate and write it down. Which I have been and it's around 80 breaths per minute. He wanted to do a MRI or a CT scan to see the lungs better but wanted to see about putting him to sleep first w/ an anesthesiologist since he has a fast respiratory rate. (We have not heard back from him..that was last week)

The pediatrican just ordered a abdominal ultrasound today and that came back normal. When I was there I picked up both chest xrays, from birth and the repeat one. I read the radiologist report and they both say that the lung appears normal but there was dextrocardia.

Can there be dextrocardia cause tachypnea and nothing wrong w/ his lungs since two seperate radiologist say that the lungs appear normal? His oxygen saturation is always 100%.
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773637_tn?1327450515
Dear Holly,

Isolated dextrocardia, in which the heart is essentially a mirror image of a left sided heart but otherwise has normal anatomy, does not cause tachypnea (fast breathing).  There can be other structural abnormalities within the chest that may cause tachypnea, which you suggest  may have been found.  If the pressures across the pulmonary arteries are normal and the cardiac anatomy, function, and flow are normal, then there should not be a cardiac etiology for the tachypnea.  Obviously, without all of the data in front of me, I cannot say for sure what the source of it is in your son.  I am not clear what is being reported when you discuss the pulmonary veins, as there are at least four pulmonary veins, not two.  We usually don't see tachypnea immediately due to pulmonary vein obstruction unless there is severe obstruction to multiple veins.  Therefore, if your cardiologist does feel that there is a structural abnormality with pulmonary vein stenosis, that may be the cause of the tachypnea.
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