Ebstein's Anomaly
Ebstein's Anomaly
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 video 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.Auscultation Sounds
Patient Recording
Patient Recording - Half Speed Playback
Position
The patient's position should be supine.
Listening Tips
S1:Increased intensity. Possible splittingSystole:Rectangular
S2:Possible splitting.
Diastole:Opening snap followed by decrescendo-crescendo murmur
Waveform (Phonocardiogram)
Observe
//embedding heart animation
Review the cardiac animation. Notice 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.
Authors
These authors contributed the audio recordings and text found in this reference guide: Jon Keroes, MD,Diane Wrigley, PA, and David Lieberman.Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
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