What dictates the position of the diaphragm--the heart or the liver? A review of sixty-five cases.

Case histories of 65 patients with cardiac malposition were reviewed to assess abdominal taxis and hemidiaphragm posture. We present their roentgenographic findings to support the hypothesis that the cardiac mass determines the caudad displacement and lower position of the related hemidiaphragm. The popular hypothesis that the liver lifts the corresponding hemidiaphragm is questioned. Incidentally, a review of their echocardiographic findings demonstrate the presence of complex congenital heart defects in a majority of these patients.