What’s the Reverse Scenario?

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Situs inversus is a rare condition that causes the organs in the chest and stomach to mirror each other. It may be called mirror image dextrocardia, although in rare cases the heart is not fully displaced to the opposite side of the chest and is called levocardia. As unique as this arrangement may seem, it is not necessarily indicative of medical problems and there are many people who are unaware that they have this condition unless they receive a thorough medical examination.

If people were able to fully view their organs in a mirror, they would essentially see what a situs inversus might look like. Everything is shifted to the opposite side with the heart present in the right side of the chest next to the lung which should be on the left side of the chest. The liver, spleen, and other organs are also typically flipped, creating the mirror image.

It is beneficial for all organs to be on the wrong side because this maintains how the organs behave with each other. Most people who have situs inversus have no problems or health problems. What becomes problematic is when only some of the organs change. Dextrocardia, heart in the right side of the chest with no other organ involvement, tends to mean a much greater likelihood of heart defects. If situs inversus occurs without dextrocardia, that can also be a problem.

While many people with situs inversus have completely healthy and normal lives, there may be some who have further problems. It is possible for heart defects to occur, although the rate of occurrence is only slightly higher than rates in people with normal organ arrangement. About a quarter of people with mirror dextrocardia also have a condition that affects the eyelashes, causing them to beat back and making people much more susceptible to disease. When situs inversus and primary ciliary dyskinesia occur together, this may be called Kartagener syndrome.

There is no treatment for situs inversus unless there are additional problems. With improved imaging technology, this particular organ arrangement can first be noticed in utero with a sonogram. Because many of the organs are tiny, it is not always clear that dextrocardia in a fetus means mirror image dextrocardia. It can mean more serious conditions and might suggest making sure mothers leave in a tertiary hospital. It should be emphasized that many heart defects could be detected in mid-pregnancy with scans such as the fetal echocardiogram.

Many wonder why situs inversus occurs, and while it is known to be a loop defect, a clear cause is not always defined. In some cases, genetics can play a role, but this isn’t always true. If the condition is inherited genetically, it is thought to occur in an autosomal recessive pattern, meaning both parents would have to carry a gene for it. Even when both parents have this gene, each child would have only a 25% chance of developing mirror-image dextrocardia.

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