Ebsteins anomaly of the tricuspid valve chest x ray

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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

The chest X Ray in Ebstein’s anomaly of the tricuspid valve may demonstrate cardiomegaly, a dilated right atrium and a pruned pulmonary vasculature.

Chest x-ray Findings

Mild Cases

The chest x-ray may be normal in patients with mild disease.

Severe Disease

  • Massive cardiomegaly with a balloon shaped globular heart. The cardiothoracic ratio can be used as a parameter to follow the patient over time.
  • Small main pulmonary artery shadow
  • Diminished pulmonary vascularity
  • Dilated right atrium
  • The left heart border becomes straight or convex due to the dilated and displaced right ventricular outflow tract.
  • Small aortic root

Chest X Ray Example

Shown below is the chest x-ray of a patient with Ebstein's anomaly which demonstrates cardiomegaly:

Ebstein's anomaly 001.jpg



Shown below is the chest x-ray of the patient with Ebstein's anomaly in whom the cardiothoracic ratio exceeds 0.5. The pulmonary vasculature is pruned, the right atrium is enlarged, and the right ventricle is enlarged.

Cardiothoracic ratio.JPG

Shown below is the chest x-ray of a patient with Ebstein's anomaly in whom the right atrium is markedly enlarged.

Ebstein's anomaly 2.JPG

Shown below is the chest x-ray showing box shaped heart in Ebstein's anomaly.

Case courtesy of Dr Vincent Tatco[1]

Limitations of the chest x-ray

The chest x-ray is nonspecific in the diagnosis of Ebstein's anomaly and a normal chest x-ray does not exclude the diagnosis of Ebstein's anomaly.

References

  1. <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/43277">rID: 43277</a>


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