Echocardiography in the Diagnosis of Ebstein's Anomaly

This study presents four patients with Ebstein's malformation of the tricuspid valve, with hemodynamic, phonocardiographic and echocardiographic investigation. The echocardiogram demonstrated right atrial enlargement and an “atrialized” right ventricular area, pronounced anterior movement of the tricuspid valve with low ejection fraction slope values and a greater than normal delayed closure and opening as compared with the mitral valve. Abnormal septal motion was found in all the cases. Echocardiographic studies, when compared with phonocardiographic and catheterization data, show that an early systolic sound occurs when the tricuspid valve reaches the limit of its systolic excursion, after functional closure of the valve. Early diastolic sounds were generally tricuspid opening snaps.