Ebsteins anomaly of the tricuspid valve electrocardiogram

Jump to: navigation, search

Ebsteins anomaly of the tricuspid valve Microchapters

Home

Patient Information

Overview

Historical Perpective

Classification

Pathophysiology

Causes

Differentiating Ebstein's Anomaly from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography

CT

MRI

Other Imaging Findings

Other diagnostic studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Case Studies

Case #1

Ebsteins anomaly of the tricuspid valve electrocardiogram On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ebsteins anomaly of the tricuspid valve electrocardiogram

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ebsteins anomaly of the tricuspid valve electrocardiogram

CDC on Ebsteins anomaly of the tricuspid valve electrocardiogram

Ebsteins anomaly of the tricuspid valve electrocardiogram in the news

Blogs on Ebsteins anomaly of the tricuspid valve electrocardiogram

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Ebsteins anomaly of the tricuspid valve electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]}; Claudia P. Hochberg, M.D.; Priyamvada Singh, MBBS [3] Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]

Overview

The EKG is abnormal in 50 to 60% of patients, and will often show signs of right atrial enlargement, including "Himalayan" P waves which are P waves greater than 2.5 mm in height in leads 2, 3, and aVF. First-degree AV block, low QRS voltage, an atypical right bundle branch block, T wave inversions, and Wolff-Parkinson-White syndrome may also be present.

EKG Abnormalities

Electrocardiographic Example

Shown below is the EKG of a woman with Ebstein's anomaly. The ECG shows signs of right atrial enlargement. The P waves in leads 2,3, and aVF are tall and greater than 2.5 mm in height. These large P waves are termed "Himalayan" P waves. There is also a right bundle branch block pattern and a first degree atrioventricular block (prolonged PR-interval) due to intra-atrial conduction delay. There is no evidence of a Kent-bundle in this patient. There is T wave inversion in V1-4 and a marked Q wave in III; these two changes are characteristic for Ebstein's anomaly and do not reflect ischemic ECG changes in this patient.

Ebstein's anomaly ECG.png

Shown below is the electrocardiogram of an adolescent with Ebstein's anomaly which demonstrates right atrial enlargement and first-degree AV block. Right Bundle Branch Block and right axis deviation are also present.

Ebsteins EKG.jpg

Source: http://www.childrenshospital.org/cfapps/mml/index.cfm?CAT=media&MEDIA_ID=1623


References

  1. VAN LINGEN B, BAUERSFELD SR (July 1955). "The electrocardiogram in Ebstein's anomaly of the tricuspid valve". Am. Heart J. 50 (1): 13–23. doi:10.1016/0002-8703(55)90250-7. PMID 14387934.
  2. Attenhofer Jost CH, Connolly HM, Dearani JA, Edwards WD, Danielson GK (January 2007). "Ebstein's anomaly". Circulation. 115 (2): 277–85. doi:10.1161/CIRCULATIONAHA.106.619338. PMID 17228014.



Linked-in.jpg