Why are more people now born with inverted organs?

“I’m on the right side, you’re turned around,” Luca Prodan sang in the ’80s. It was a metaphor, but for some people it is a literal reality.

Medicine designates with the name of reverse site (“inverted position”) to those individuals who They are born with inverted internal organsas in a mirror.

That is, with the heart on the right, the liver on the left… even the intestines, in their twisted extension, are the opposite of what they are in most people.

“It is about an extremely rare conditionit occurs in approximately one in 10,000,” he tells Viva Dr. Amalia Elizari, cardiologist, head of the Adult Congenital Heart Disease section at the Cardiovascular Institute of Buenos Aires (ICBA).

The advancement of health sciences in recent years has allowed the development of a specialty such as Fetal Medicine, which follows the gestation period in its different stages and is capable of detect heart abnormalitieslike the reverse sitealready from the fetus. The sooner it is detected, the better.

“What matters is detection. In severe cases, which require surgery, early diagnosis helps determine the most opportune time to perform an interventionwhich will be within the first year of life,” says Elizari. It is important to act in time, as in any health issue.

Most people, however, discover by accident that they have the condition: “The person takes a chest x-ray and there they see the heart on the right, the gastric chamber on the right; then it is identified that there is an inversion of organs,” exemplifies the specialist.

This is what happened to entertainment figures such as the singer Enrique Iglesias or the actress Catherine O’Hara (the mother of My poor little angel), who spent a good part of their lives without even knowing that inside the “furniture” of the body was all upside down.

An extreme case was known in 2019, in Oregon, United States. A woman donated her body to science, and in a subsequent anatomy class it was discovered that she had reverse site; The woman had died at the age of 99 without knowing her physical condition..

It would seem, then, that it is a congenital disorder that does not prevent lead a completely normal life. This is true for most cases, but not all.

To begin with, there are various types of organ inversion. This inversion can be total – all the organs of the thorax and abdomen, including veins and arteries, are “turned over” – or partial, when only one organ is inverted.

The most common is the total investment, but the good news is that this does not entail no type of associated pathology: although all the organs are on the “wrong side”, they maintain the same relationships with each other as in the case of people with your organs in the usual position.

In fact, the condition It is not an obstacle to practicing high-performance sports.and the proof of this is the American Randy Foye, who developed a successful career as a basketball player in the demanding NBA between 2006 and 2017.

On the other hand, problems may arise when the inversion is partial, that is, one or more organs inverted (often the heart).

“When the cardiac situation is not complex,” says Elizari, “the most common problem is a defect between the atria. Most of the time (more than 90 percent) This can be resolved by catheterization.without the need to operate.”

An example of this last case is that of Diego (40), who has only his heart invested and gave his testimony to Viva:

“When the doctors found that my heart was inverted, they explained to me that a cardiac evaluation had to be done. There they found what is called an atrial septal defect, which It’s like a hole in the heart. They had to perform a procedure on me, which could be done by catheterization and everything went well. I have already solved the problem and there is no particular care I need to take, other than knowing that cardiac orientation.”

Although the person can lead a perfectly normal life, it is important to be aware of this congenital condition.

In the case of appendicitis, for example, the diagnosis will be more difficult if the inversion of organs is unknown, since the patient will have as a symptom a sharp pain on the left sideinstead of the usual one, which is on the right side.

The condition has been known since Antiquity: The Greek philosopher and scientist Aristotle had already observed it in animals and, many centuries later, Leonardo da Vinci was the first to verify it in human beings from his anatomy studies on cadavers. But only at the end of the 19th century was its diagnosis made using x-rays, a method that became standard from then on.

However, we had to wait until well into the 20th century and the further development of genetic engineering to know the causes that cause this rearrangement of the organs of the thoracic-abdominal region.

Today it is known that the reverse site It is caused by a genetic mutation in which more than 100 genes are involved, although there are still more to be done. clarify some points to have an exact overview of all the factors involved in the anomaly.

In any case, the condition is inherited through recessive transmission, meaning that both parents must pass on an altered gene to your child so that he or she inherits the genetic condition.

An example of what remains to be known about this took place at the end of 2023, when an unusual increase (up to four times more) in cases of reverse site in China.

The researchers noticed a correlation with an increase in Covid casesjust after China lifted virus restrictions at the end of 2022.

A study that appeared in May of this year in the publication Scientific Reportscarried out by a team of doctors from the city of Jinan, China, confirmed this first evaluation: “SARS-CoV-2 infection during the first trimester increases significantly the risk of fetal left-right asymmetry disordersparticularly when infection occurs between weeks 5 and 6 of gestation. The most common associated malformation is cardiac malformation.”

It is still unknown how the virus would affect the mutation that gives rise to the reverse sitebut this is a strong indication that external factors can favor this alteration.

Fiction has been able to take advantage of this anomaly. One of James Bond’s great enemies, the Dr. Nowas saved from an assassination attempt because they shot him accurately in the heart. The killer was unaware that Bond’s nemesis suffered from reverse site.

In one of those cases in which reality imitates fiction, in 2020, the case of a man who was shot in the chest and after several surgeries he recovered satisfactorily.

Without reaching these extremes, suffering from reverse site It can be little more than a curiosity (like driving a car on the right in London, but without even noticing the difference).

For the few cases in which it can represent a health risk, fortunately today science has the appropriate tools to restore the necessary balance in a minimally invasive way.

Because, as they say, the order of the factors does not alter the product.