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Ebstein’s Anomaly

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Ebstein’s anomaly is a rare congenital heart defect of the tricuspid valve (one of the four heart valves that allow blood to flow from the right atrium, or top chamber, into the right ventricle, or bottom chamber of the heart). This defect can lead to heart enlargement or heart failure. When the defect is diagnosed in an infant, it is usually a severe case of cyanosis (bluish coloration of the skin due to low oxygen levels in the blood).

Symptoms of the condition depend on the degree of displacement of the tricuspid valve and the presence of associated defects. Some patients require repair or replacement of the tricuspid valve.

Why Choose The Ohio State University Medical Center?

Anyone who has ever been diagnosed with and/or treated for Ebstein’s anomaly should have lifelong care from a cardiologist who specializes in congenital heart defects. The Ohio State University Medical Center provides this care from birth to adulthood. We partner with Nationwide Children’s Hospital to provide the resources necessary for the care of adult congenital cardiac patients through the Columbus Ohio Adult Congenital Heart Disease Program (COACH).

  • The COACH program focuses on:
  • Adults with congenital heart disease (CHD)
  • Pulmonary hypertension
  • Cardiovascular connective tissue disorders
  • Pregnancy in women with heart disease
  • Transition of adolescents with CHD into adult congenital heart disease (ACHD) care
  • Training of future ACHD providers

Ohio State’s Medical Center offers a team approach to CHD, which means each patient is evaluated by an Adult Congenital Heart Disease (ACHD) specialist, and when appropriate, a cardiac surgeon, an imaging specialist and an interventional cardiologist with training in CHD. This integrated approach means that each patient’s disease is treated individually, with that particular patient’s needs, and physical condition, in mind.

What Is Ebstein’s Anomaly?

In Ebstein’s anomaly, the defective tricuspid valve is in the wrong location in the heart, which causes:

  • The right atrium of the heart to be larger than normal
  • The tricuspid valve leaflets (flaps) to be abnormally formed
  • Blood to leak back through the valve

In many cases, there also is a hole (atrial septal defect) in the wall between the two upper chambers of the heart. As a result, the heart functions inefficiently.

Cases of Ebstein’s anomaly range from mild to severe and there may not be any symptoms. When symptoms do occur, they can include:

  • Shortness of breath
  • Fatigue
  • Swelling in the legs
  • Heart palpitations
  • Bluish skin coloration from low oxygen levels

What Causes Ebstein’s Anomaly?

Ebstein’s anomaly is a congenital heart defect that occurs during fetal development. The precise cause is unknown, but genetics may play a role.

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Diagnosis of Ebstein’s Anomaly

Due to improvements in technology, some congenital heart defects can be detected before a baby is born. In other cases, severe heart defects are detected shortly after birth. Some cases of less severe disease may not be detected until childhood, late adolescence or even adulthood.

Tests used to diagnose Ebstein’s anomaly include:

Electrocardiogram (EKG/ECG) – A test that records the electrical activity of the heart.

Echocardiogram (also called echo) – A test that uses sound waves to assess the function and structure of the heart muscle and valves.

Chest X-ray – A radiograph or picture of the heart and lungs including blood vessels, ribs and bones of the spine.

Cardiac MRI (cardiac magnetic resonance imaging or CMR) – A noninvasive, sophisticated imaging procedure that uses large magnets and a computer to produce detailed images of the structure and function of the heart while it is beating.

Cardiac catheterization – A procedure to measure the pressures inside the heart and check for problems in the coronary arteries. A long, thin tube (catheter) is inserted into an artery or vein in the groin, arm or neck, and then threaded to the heart. The physician injects a contrast solution into the artery and takes X-rays to check for blockage and other abnormalities.

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Treatment of Ebstein’s Anomaly


Medications may help relieve symptoms of Ebstein's anomaly, such as heart rhythm abnormalities and heart failure. Medications prescribed may include:

Nonsurgical Procedures

Radiofrequency catheter ablation is a minimally invasive procedure that can help to treat the heart rhythm problems associated with Ebstein's anomaly, in some cases.


Adults who have this condition often do not need surgery but your physician may recommend it if your symptoms become problematic. The defective valve cannot be made normal with repair, but it can be treated to improve symptoms. Surgical procedures include:

  • Tricuspid valve repair
  • Tricuspid valve replacement
  • Closure of the atrial septal defect
  • Thoracoscopic maze procedure (for treatment of heart rhythm problems)

Heart transplantation may be necessary for severe cases of Ebstein's anomaly.

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Ohio State Medical Center Physicians Who Treat This Condition

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