A recent report in the New England Journal of Medicine describes a rare case of a man whose heart rotated in his chest and ended up on the right side following a motorcycle accident.

A 48-year-old-man was taken to the emergency department in an Italian hospital for chest trauma which resulted from the accident. Following a cardiac exam to gather information on his heart rate and rhythm the medical team had their suspicions that he may be presenting a case of dextrocardia, which is where the heart is situated on the right side of the body as opposed to the left.

Subsequent chest X-rays and a CT scan demonstrated that the heart had rotated 90 degrees to the right. He also sustained other injuries including multiple rib fractures and pneumothorax, which is a collection of air in the pleural cavity that causes the lung to collapse. After carrying out a total-body CT scan they found that the pulmonary artery, aorta, both atria and both ventricles had rotated to the right.

“This is a very interesting anatomical finding, and it’s very unusual,” said Dr. Gregory Fontana, chairman of the department of cardiothoracic surgery at Lenox Hill Hospital in NYC, who was not involved in the case. “I had never seen anything like it. What’s unique about this case is the way the heart had rotated so far in the other direction, and the patient was still awake and alert,” Fontana told Live Science.

According to Fontana, the leaked air that collected outside of the lungs as a result of the accident probably pushed and rotated the heart, rather than the force of the accident. The NEJM report states that the man underwent chest drainage and 24 hours later his heart reverted back to its original position. He also had to have his spleen removed in an emergency procedure.

A follow-up investigation found that despite the trauma, which temporarily constricted his blood vessels, the man’s heart did not appear to have sustained any damage. “It’s an amazing thing about medicine- that there are so many things we haven’t seen yet, and will see in the future with great fascination,” Fontana told Live Science.