Abstract
A 62 year old lady, diagnosed with Ebstein malformation 12 years ago, presented to clinic with severe fatigue, breathlessness, chest pain, palpitations, and loss of weight. She had clear evidence for irregular rhythm, rales at the basal lung fields and clinical signs of severe right sided failure. A 12 lead ECG showed atrial fibrillation with wide QRS complex (130 ms) and right bundle-branch block. Echocardiography showed septal tricuspid valve leaflet displacement of 1.6 cm into the right ventricle (Figure 1&2). The right atrium was enlarged, 70 x 110 cm in diameter, with moderate tricuspid regurgitation and estimated pulmonary hypertension of 90 mmHg. In addition, there was an echo dense mass (26 x 30 mm) attached to the left atrial side of the interatrial septum, with morphologic appearance consistent with atrial myxoma. According to our knowledge, this case of such combination seems the first reported in the literature.
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