ABSTRACT
A right-sided aortic arch causes a right lateral indentation and a double arch is responsible for a ‘reverse S’, or impressions on both sides of the oesophagus. The differential diagnosis of a pedunculated intracardiac lesion includes atrial myxoma and papillary fibroelastoma. Papillary fibroelastomas are rare lesions that are typically asymptomatic. Situs invertus describes reversal of the thoracic and abdominal organs in a mirror-image fashion. Situs solitus refers to normal orientation. Severe pectus excavatum can lead to an abnormal position of the heart towards the right of the midline. Signs on the frontal radiograph can be subtle, and it is more easily seen on the lateral radiograph.
