Ebsteins anomaly of the tricuspid valve physical examination

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]

Physical Examination

General Appearance

Patients may have a bluish coloration of their face depending on the degree of cyanosis and right to left shunting.

Heart

Because the RA is dilated and compliant, there are no large v waves even in the presence of TR (tricuspid regurgitation) and the jugular venous pressure is often normal on exam. The chest may be asymmetric due to an enlarged right heart.

The first heart sound is widely split. There is a wide split S2 as a result of RBBB and delayed closure of the pulmonic valve. TR (tricuspid regurgitation), produces a holosystolic murmur which is heard best along the left lower sternal border and increases with inspiration.