Dextrocardia is evident as the apex is pointing to the right and the right atrial contour is on the left. The gastric air bubble is on the right (below the diaphragm) and liver shadow on the left, indicating situs inversus. The ascending aortic shadow on the left is a little prominent. There is mild scoliosis with convexity to the left which could be partly positional. Crowding of upper ribs on the right side could be due to the scoliosis.
Left sided pleural effusion with dextroposition
There is massive pleural effusion on the left side pushing the heart along with the mediastinum to the right side producing a dextroposition. The higher level of the effusion in the axilla is evident. The liver shadow is on the right side indicating situs solitus. Stomach air bubble is not visible well.
Dextroposition of the heart can also be due to congenital hypoplasia of right lung [1,2].
Wang Y, Yang X, Dong L, Shu X. A curious case of cardiac dextroposition. Eur Heart J. 2014 May;35(18):1185.
Baranchuk A, Somani R, Simpson CS, Michael KA, Redfearn DP. Ablation of a left lateral accessory pathway in a patient with dextroposition of the heart. Cardiol J. 2012;19(4):439-40.