Ebstein’s anomaly with Severe Right Ventricular Dysfunction: Echocardiographic features
Akhil Mehrotra*1, Mohammad Shaban2 and Faiz Illahi Siddiqui2
1Chief, Pediatric and Adult Cardiology, Prakash Heart Station, Nirala Nagar, Lucknow, UP, India
2Cardiac Technician, Prakash Heart Station, Nirala Nagar, Lucknow, UP, India
*Corresponding author
*Akhil Mehrotra, Chief, Pediatric and Adult Cardiology, Prakash Heart Station, Nirala Nagar, Lucknow, UP, India
Figure 1: Transthoracic echocardiography. (A) Apical 4C view shows apically displaced small septal leaflet and large, sail like and redundant anterior leaflet of TV. FRV, functional right ventricle; TV, tricuspid valve; AML, anterior mitral leaflet; LV, left ventricle; mv, mitral valve.
- Moderate ostium secundum ASD of size 4.5 mm with right to left shunt (Figure 2).
Figure 2: (A) Moderate size ostium secundum ASD detected in the subcostal view; (B) Right to left shunt demonstrated across ASD. ra, right atrium; rv, right ventricle; lv, left ventricle; mv, mitral valve; la, left atrium.
- Severe TR with a jet area of 9.67 sqcm, occupying nearly whole of RA with a TR velocity of 2.6 m/sec (Figure 3).
Figure 3: On color flow mapping, a severe TR jet with an area of 8.54 sqcm is clearly demarcated in the apical 4C view; TR, tricuspid regurgitation; RV, right ventricle; RA, right atrium; VS, ventricular septum; LV, left ventricle.
Severely reduced FRV EF (20 %) with normal LV dimension and LVEF (70 %).
Subsequently, the patient’s attendants were advised immediate surgical correction of EA and the infant was referred to a tertiary care pediatric cardiovascular institute.
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