Ebstein's Anomaly

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This is an example of Ebstein's Anomaly as heard at the tricuspid area.

The first heart sound is increased due to thickening of the tricuspid valve leaflets.

The second heart sound is normal.

A rectangular murmur of tricuspid regurgitation fills all of systole.

An opening snap occurs 100 milliseconds into diastole followed by a decrescendo-crescendo murmur of mitral stenosis.

These findings are all a manifestation of downward displacement of the tricuspid valve into the right ventricle

In the anatomy tab you can see the enlarged right atrium and the small right ventricle. The upward plume from the right ventricle to the right atrium represents the systolic murmur.

The downward plume from the right atrium to the right ventricle represents the diastolic murmur.

This abnormality is congenital in nature.

Ebstein's Anomaly
The recommended auscultation position for the stethoscope is the Tricuspid position. For this sound, use stethoscope's Diaphragm.


maneuver
The recommended patient position is Supine

Phonocardiogram

waveform
This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.

Heart Animation

Lessons
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Listening Tips
A synopsis of important sound features and timing for this abnormality.
S1: Increased intensity. Possible splitting.
Systole: Rectangular.
S2: Possible splitting..
Diastole: Opening snap followed by decrescendo-crescendo murmur.
CaseID117
CourseID29
CourseCaseOrder6
ID109