After surviving traumatic injuries due to a motorcycle crash in Italy, an X-ray and CT scan revealed that a 48-year-old man’s heart had rotated 90 degrees to the right within his body. Dr. Andrea Colli and Dr. Enrico Petranzan, both from the University of Padua in Padua Italy, co-authored a report in the New England Journal of Medicine detailing an account of the unusual medical diagnosis.

"I had never seen anything like it," chairman of the department of cardiothoracic surgery at Lenox Hill Hospital in New York City Dr. Gregory Fontana Fontana told LiveScience. "What's unique about this case is the way the heart rotated so far in the other direction, and the patient was still awake and alert,"

Upon suffering a punctured lung, broken ribs, and a ruptured spleen as a result of his accident, the man was taken to a nearby hospital’s emergency department where doctors began diagnostic testing. Doctors say the accident itself did not cause the man’s heart to rotate and that it most likely occurred within the hour following the crash.

The man’s punctured lung had caused air to release out of the lungs and into the space around his chest. The buildup of air pushing on his heart presumably caused it to rotate within his chest. Upon draining the air 24 hours later, doctors were able to turn the man’s heart back to its original position. While the heart itself was left uninjured, blood vessels obstructed by the rotation caused a drop in the patient’s blood pressure.

"This is a very interesting anatomical finding, and it's very unusual," Fontana added. "The structures in the back of the heart, and the big arteries, are fixed to the spine and to the tissue, but the heart kind of floats around in the sac around it.”

Aside from emergency spleen removal and a few broken ribs, doctors say the man is expected to make a full recovery from his injuries. A follow-up CT scan revealed no permanent damage to the heart muscle including heart valve dysfunction, torn blood vessels, or impaired cardiac contraction. 

New England Journal of Medicine New England Journal of Medicine