Ebstein's Anomaly in a 74-year-old Man

ABSTRACT

Ebstein's anomaly of the tricuspid valve is a rare cardiac malformation, which constitutes>0.5% of all congenital heart disease. The basic malformation of Ebstein's anomaly is displacement of septal and posterior leaflets of the tricuspid valve from the normal atrio-ventricular annulus into the body of right ventricle. Recently, an old man complained cough, dyspnea and sputum production at our hospital. His chest X-ray showed left lower lung atelectasis and cardiomegaly. Bronchoscopic study revealed nonspecific inflammatory change in the left lower lung bronchus. In echocardiographic study, there are dilated right atrium, downward displacement of the tricuspid valve into the right ventricle and moderate degree of tricuspid valve regurgitation. These echocardiographic findings were suitable for diagnostic criteria of Ebstein's anomaly. The atelectasis was resolved by antibiotic therapy, and he has been managed by ACE inhibitor and diuretics through our outpatient department. The clinical manifestation and prognosis of Ebstein's anomaly are quite variable, and considerable proportions of the patients are able to survive through their adult life, but extremely rare cases exist until old age. Recently, I experienced a case of Ebstein's anomaly in a 74-year-old man, such old case is very rare, thus report this case with review of literature.