Ebstein Anomaly Associated With Left Ventricular Noncompaction

Abstract

A 56-year-old woman with gradually progressing exertional dyspnea was referred to our hospital. She had a known diagnosis of Ebstein anomaly and patent foramen ovale since childhood. One year previously, she had presented with a transient ischemic attack that was thought to be secondary to a paradoxal embolism through the patent foramen ovale, so an Amplatzer occluder had been implanted. Clinical examination revealed a normal sinus rhythm at 56 bpm and a New York Heart Association class II dyspnea without cyanosis. ECG (Figure 1) showed a first- degree atrioventricular block with a pattern of complete right bundle-branch block. Chest radiography (Figure 2) demonstrated mild cardiomegaly and clear lung fields. Two-dimensional echocardiography showed malposition of the anterior and septal tricuspid valve leaflets with grade 2 tricuspid regurgitation. The atrial septal occluder was in correct position without residual shunt. In …