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

Echocardiogram

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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