Impact on anatomy
The condition affects all key structures inside the thorax and abdomen. Commonly, the organs are basically transposed by way of the sagittal plane. The heart is situated on the ideal side of the thorax, the stomach and spleen on the ideal side of the abdomen and the liver and gall bladder on the left side. The left lung is trilobed and the ideal lung bilobed, and blood vessels, nerves, lymphatics and the intestines are also transposed.

If the heart is swapped to the ideal side of the thorax, it is identified as situs inversus with dextrocardia or situs inversus totalis. If the heart remains in the typical left side of the thorax, a considerably rarer condition (1 in 22,000 of the common population), it is identified as situs inversus with levocardia or situs inversus incompletus. Situs inversus with levocardia, or dextrocardia without having situs inversus, present considerably greater rates of congenital defects than situs inversus with dextrocardia.

Significance
Situs inversus has an autosomal recessive pattern of inheritance.
Situs inversus is commonly an autosomal recessive genetic condition, while it can be X-linked or identified in identical mirror twins.

In the absence of congenital heart defects, people with situs inversus are phenotypically unimpaired, and can lead typical wholesome lives, without having any complications related to their medical condition. There is a 510% prevalence of congenital heart illness in people with situs inversus totalis, most frequently transposition of the really good vessels. The incidence of congenital heart illness is 95% in situs inversus with levocardia.

Most many people with situs inversus totalis are unaware of their unusual anatomy until they seek medical attention for an unrelated condition. The reversal of the organs might possibly then lead to some confusion, as most signs and symptoms will be on the wrong side. For example, if an individual with situs inversus develops appendicitis, they will present to the physician with lower left abdominal discomfort, due to the fact that is exactly where their appendix lies.

Therefore, in the event of a medical predicament, the expertise that the individual has situs inversus can expedite diagnosis. Many people with this rare condition might possibly inform their physicians ahead of an examination, so the physician can redirect their search for heart sounds and other signs. Wearing a medical identification tag can support to inform well being care providers in the event the individual is unable to communicate.

Situs inversus also complicates organ transplantation operations as donor organs will just about absolutely come from situs solitus (typical) donors. As hearts and livers are chiral, geometric challenges arise placing an organ into a cavity shaped in the mirror image. For example, a individual with situs inversus who calls for a heart transplant wants all the vessels to the transplant donor heart reattached to their existing ones. In spite of this, the orientation of these vessels in a individual with situs inversus is reversed, necessitating actions so that the blood vessels join effectively.

Kartagener syndrome
Further specifics: main ciliary dyskinesia
About 25% of people with situs inversus have an underlying condition identified as main ciliary dyskinesia (PCD). PCD is a dysfunction of the cilia that manifests itself in the course of the embryologic phase of development. Ordinarily-functioning cilia identify the position of the internal organs in the course of early embryological development, and so people with situs inversus have a 50% chance of creating PCD. If they do, they are mentioned to have Kartagener syndrome, characterized by the triad of situs inversus, chronic sinusitis, and bronchiectasis. Cilia are also responsible for clearing mucus from the lung, and the dysfunction causes elevated susceptibility to lung infections.

Notable persons with situs inversus
Notable people with documented situations of situs inversus incorporate:
Randy Foye, an American basketball player in the NBA. He has suffered no discernible complications, and the condition is not expected to jeopardize his career as a skilled athlete.
Catherine OHara, the Canadian comedic actress, has mentioned in interviews that her organs are reversed and her heart is on the ideal side of her chest.

Fictional characters with situs inversus
In the Ian Fleming novel Dr. No, Julius No explains to James Bond that he when survived a murder attempt given that his heart is situated on his ideal side, which his would-be-killers did not know when they stabbed the spot on the left exactly where the heart of a typical human getting would be.

Souther, from the anime/manga Fist of the North Star, has situs inversus totalis, producing him immune to common pressure-points martial arts.

In the WB series Jack andamp Jill, Simon Rex played a young man with situs inversus.
Fortune, from Metal Gear Solid two: Sons of Liberty. Revolver Ocelot points this out when he shoots Fortune on the left side of her chest, then remembers and states that her heart was on the ideal side.
In an ER Series entitled Freak Show, Romano, Benton and Corday operate on a one of a kind case involving a boy with reversed organs.
In a story named The Trap, which H. P. Lovecraft helped write, 1 of the characters is sucked into an interdimensional rift by an antique mirror. When he returns his organs, and in truth his manual dominance (i.e. He was ideal-handed but is now left-handed), are each reversed.
In Margaret Mahys novel The Tricksters, the character Hadfield is mentioned to be an precise mirror image of his otherwise identical twin Felix, like getting his crucial organs in mirror-image layout.
In the Lord Peter Wimsey brief story The Image in the Mirror by Dorothy Sayers, a character with reversed organs has lengthy been haunted by dreams of a doppelgnger and by fears that he himself could possibly be only the reflection of a person else.
In the Max Brooks novel Planet War Z, a character describes operating on a patient who had dextrocardia with situs inversus, and transplants a heart from a person with the very same condition. Unbeknownst to him, the transplant heart is infected with the virus Solanum, therefore turning the patient into a zombie.
In the science fiction novel Doorways in the Sand by Roger Zelazny the character Fred Cassidy goes by way of a device that absolutely reverses the left-ideal symmetry of his whole body (even to the point exactly where he perceives writing and other images as their mirror image). The truth that his heart is on the wrong side ends up saving him from getting killed by a bullet wound.
In the science fiction brief story Technical Error by Arthur C. Clarke, a man is inverted extradimensionally in a powerful magnetic field due to an industrial accident. Doctors acquire he is unable to digest food due to the nutrient molecules getting incompatible with his reversed enzymes and receptors. Efforts to re-invert him prove catastrophic.
In Luck (film) Hindi movie(2009), the character Ram has heart on ideal side rather of left which saves him in the end.
In Audrey Niffeneggers novel, Her Fearful Symmetry, the most important characters are mirror twins, 1 of whom, Valentina, has situs inversus.
In the movie Ninja Assassin, a Europol agent Mika gets stabbed exactly where her heart should certainly be. Every person thinks her to be dead, but then she proclaims that her heart is on the other side and survives. Also, in the beginning of the movie there is an old man who should certainly have died from a sword to the heart, but it was situated on the ideal side of the body as properly.
In 1 Piece, when Sanji was attacked by Eniel, Ussop thought that Sanji had died but essentially Sanji had his heart on the ideal side.
See also
Situs solitus
Situs ambiguus
Ectopia cordis
Asplenia
Polysplenia
Chirality (mathematics)
Johann Friedrich Meckel, the Elder
References
^ Situs inversus on eMedicine
^ [Gedda L, Sciacca A, Brenci G, Villatico S, Bonanni G, Gueli N, Talone C. Situs viscerum specularis in monozygotic twins. Acta Genet Med Gemellol (Roma) 1984 33(1): 81-five.]
^ http://wcco.com/sports/Minnesota.Timberwolves.Randy.two.371610.html Rookie T-Wolfs Organs Reversed
^ http://www.cbc.ca/thehour/video.php id=2048 The Hour – two Minutes: Catherine OHara
McManus, Chris (2002). Ideal Hand, Left Hand. Harvard University Press. ISBN -674-00953-three.and#160 this book was the 2003 Aventis winner and has a description of the history behind the discovery of this medical condition.
Yokoyama T, Copeland NG, Jenkins NA, Montgomery CA, Elder FF, Overbeek PA (1993). Reversal of left-ideal asymmetry: a situs inversus mutation. Science 260 (5108): 679682. doi:10.1126/science.8480178. PMID 8480178.and#160
Lowe LA, Supp DM, Sampath K, et al. (1996). Conserved left-ideal asymmetry of nodal expression and alterations in murine situs inversus. Nature 381 (6578): 158161. doi:10.1038/381158a0. PMID 8610013.and#160
Levin M (1997). Left-ideal asymmetry in vertebrate embryogenesis. Bioessays 19 (4): 287296. doi:10.1002/bies.950190406. PMID 9136626.and#160
Levin M, Pagan S, Roberts DJ, Cooke J, Kuehn MR, Tabin CJ (1997). Left/ideal patterning signals and the independent regulation of numerous aspects of situs in the chick embryo. Dev. Biol. 189 (1): 5767. doi:10.1006/dbio.1997.8662. PMID 9281337.and#160
Logan M, Pagn-Westphal SM, Smith DM, Paganessi L, Tabin CJ (1998). The transcription factor Pitx2 mediates situs-distinct morphogenesis in response to left-ideal asymmetric signals. Cell 94 (three): 307317. doi:10.1016/S0092-8674(00)81474-9. PMID 9708733.and#160
Stern CD, Wolpert L (2002). Left-ideal asymmetry: all hands to the pump. Curr. Biol. 12 (23): R802803. doi:10.1016/S0960-9822(02)01312-X. PMID 12477404.and#160
External links
00698 at CHORUS
Categories: Genetic disorders | Autosomal recessive disorders | Motor abilities | Rare illnesses


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