Ebsteins anomaly of the tricuspid valve echocardiography or ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] and Claudia P. Hochberg, M.D. [2]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]}; Keri Shafer, M.D. [4] Priyamvada Singh, MBBS [[5]]

Assistant Editor-In-Chief: Kristin Feeney, B.S. [[6]]

Overview

Echocardiography

Fetal echocardiography helps in intrauterine diagnosis of Ebstein's anomaly

Two-dimensional echocardiography along with Doppler ultrasonography helps in making a diagnosis of Ebstein's anomaly. Echocardiography helps in

  • Identifying the lesion,
  • Determining the severity of dilatation of the right atrium
  • Finding other associated cardiac defects that may be present.
  • Finding the functional status of the tricuspid valve as well as the right ventricle

Findings on echo are-

  • Apical displacement of the anterior tricuspid valve leaflet
  • 'Atrialized' proximal portion of right ventricle. This occurs due to anterior displacement of tricuspid valve leaflet.
  • Tricuspid regurgitation presenting as paradoxical septal motion.
  • Patent foramen ovale or atrial septal defect may present as right to left shunting.
  • Normally the tricuspid valve closes within 30 msec of the mitral valve. In Ebstein's, the tricuspid valve closes 50 to 60 msec after the mitral valve.
  • The delayed tricuspid closure is not due to RBBB because it also occurs with preexcitation.
  • 2D ECHO allows you to assess whether the repair can be accomplished without a prosthetic valve, and detects whether an interatrial shunt is present.

See Echo in Ebstein's anomaly of the tricuspid valve for more info/images

Below is an apical 4-chamber transthoracic view, showing apically-displaced leaflets of the tricuspid valve. Note substantial tricuspid regurgitation, which originates close to the apex, where the abnormal leaflets actually coapt:

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References

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