Dextrocardia without heart mirroring !

[mehrdad_ati]

Im a med student and i was always thinking my 23 year old younger brother had situs inversus since he had no signs or symptoms (only heart sounds are heard in right hemithorax) . he was even wrestling professionally a couple of years ago .

three month ago he told me that he had cycles of nasal congestion for a while so i thoght about kartagener syndrome and primary ciliary dyskenasia but while he didn't have any signs in the last 23 years i didn't take it seriously.

but after he returned home yesterday he still had that nasal congestion and i could hear  fine crackles across all parts of his left lung.(right lung seemed clear) so i decided to take a CXR finally !! and i was surprised when i saw the results !

http://pictub.club/image/KDdO2

im studying medicine for 5 years and i have never seen something like this before ! its not like a regular situs inversus ! the hear is right sided but its not mirrored ! also the  seem to be bowel loops instead of stomach (he has no digestional problems) . and i cant say where the liver is based on this x-ray (althogh i can say the liver must be  on the right side based on finger tapping)

so what do you think ? is this some sort of situs inversus ? why didn't he have any signs in the past 20 years ? should i still  for kartagener syndrome