A Case of Ebstein's Anomaly Combined with Patent Foramen Ovale

Han, Jae Ryong; Hong, Suk Kyung; Choi, Hyun; Lee, Seung Chul; Chun, Kyung Il; Kim, Yung Chul; Chung, Kyung Tae; Park, Soon Chang

Abstract

Ebsteins anomaly is characterized by a downward displacement of the tricuspid valve into the right ventricle. Its anatomical abnormality is displacement of septal and posterior leaflets of tricuspid valve from atrioventricular ring into the body of right ventricle and therefore a portion of right ventricle is atrialized. The primary hemodynamic anomaly producing symptoms in Ebsteins malformation is tricuspid regurgitation. Its natural history and clinical features depend on the drgree of displacement of tricuspid leaflets from atrioventricular ring. Although most patients with Ebsteins anomaly are diagnosed in early children, some patients with a mildly deformed tricuspid valve may remain asympto- matic well into adulthood. Most common complaints adult-onset disease are exertional dyspnea, fatigue, palpitation and cyanosis. In rnost cases the physical exarnination, electrocardiogram, and roentgenogram are sufficiently to allow the diagnosis. But, recently echocardiography has played an important role in the recognition of Ebsteins anomaly because two-dimensional echocardiography provides direct visualization of the abnormally displaced tricuspid valve apparatus. So echocardiography has replaced angiography as the procedure of choice for diagnostic and morphologic assessrnent of patients with Ebsteins anomaly. We experienced a 67-year-old female patient with Ebstein's anomaly that was definitely diagnosed by two-dimentional echocardiography. We report this case with literature review.