A Case of Ebstein's Anomaly Surviving to the Age of 79

Abstract

In 1866 Ebstein described an uncommon congenital abnormality in which the tricuspid valve was situated below its normal site, thus reducing the size of the functioning right ventricle. Since then, many examples have been recorded, some with " patent foramen ovale," and others without it; the most recent was by Kerwin (1955), who described a case diagnosed during life. In Abbott's series of 16 examples of Ebstein's anomaly, the oldest survived to 56 years. The present case is believed to be the longest survival yet recorded, and was a woman of 79 who succumbed to suppurative cholangitis.Case Report A woman, aged 79, was admitted to the West Middlesex Hospital in October, 1954, with a diagnosis of obstructive jaundice. She had been well until two days before admission, and had never complained of shortness of breath or of swelling of the ankles, though a relative said that the patient did go blue on undue effort, particularly in cold weather.

Ebstein's Anomaly

“…Coronary atherosclerosis may well have been responsible for this phenomenon in the elderly patient described by Adams and Hudson. 17 The P-wave abnormalities are an equally consistent feature of the electrocardiogram in Ebstein's anomaly.25 Tall, broadened P waves characteristically occur in precordial leads overlying the right atrium and in the limb leads, reflecting the potential developed in this chamber. The increased amplitude of these P waves is clear evidence of hypertrophy of the right atrium.…”

First presentation of Ebstein’s anomaly in an 80-year-old female patient and unusual occurrence of psychiatric illness in her male offsprings

“…In 1956, one report was published which described the patient of Ebstein's anomaly, who died at 79 years of age. 13 In 1979, another report was published about Ebstein's anomaly patient, who died at 85 years of age. 14 In 2008, the case was reported about a 77-year-old man with congestive heart failure due to a previously diagnosed condition of Ebstein's anomaly.…”

Color Doppler flow pattern in antenatal diagnosis of unguarded tricuspid valve

“…Ebstein's malformation has an extremely variable natural history depending on the degree of abnormality of the tricuspid valvular apparatus, which may range from mild to severe8. Severe tricuspid valve abnormality leads to profound congestive heart failure, whereas mild displacement of the hinge of the valve away from the atrioventricular junction may remain asymptomatic until late in adult life, or the person may remain symptomless throughout life9. The routine four‐chamber view of the heart at 18–20 weeks of gestation reveals a dilated right atrium with a rudimentary mural leaflet of the tricuspid valve.…”