Introduction: Ebstein’s anomaly is a rare congenital heart disorder occurring in ≈1 per 210 000 live births and accounting for <1% of all cases of congenital heart disease. In ebstein anomaly there is downward displacement of the septal and posterior leaflets of tricuspid valve into the RV cavity, resulting in functional hypoplasia of RV.

Case Report: Full term appropriate for gestational age female child born by vaginal delivery, without any antenatal complications, APGAR at birth 8/10, did not require any resuscitation was admitted in NICU in view of cyanosis. Auscultation revealed murmur and saturation was 75-77% in all 4 limbs. Clinical features revealed persistant tachycardia, gallop rhythm, suggestive of congestive cardiac failure. The baby had multiple episodes of supra ventricular tachycardia which responded to anti-arrhythmic agents including intravenous adenosine, intravenous beta blocker, followed by oral beta blocker.

The chest x-ray showed cardiomegaly with oligemic lung fields. ECG had tall peaked P wave with RBBB. In 2 D echo there was right atrial dilatation with apical displacement of septal leaflet of tricuspid valve suggestive of ebstein anomaly. Cardiac CT confirmed ebstein anomaly. Anti-failure medication continued and baby was considered for surgical intervention on oral anti-arrhythmic medications.

Keywords: Congenital heart disease, ebstein’s anomaly, supraventricular tachycardia

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Dr Shaista Parween

M.D. Pediatrics, Junior Resident, Department of Pediatrics, Grant Govt Medical College, Mumbai