Moradi Bahieh, Roshanali Farideh
Day General Hospital, Tehran, Iran.
J Tehran Heart Cent. 2017 Jan;12(1):39-41.
Ebstein's anomaly is defined as the significant apical displacement of the tricuspid valve causing tricuspid regurgitation. Although a variety of concomitant lesions have been previously described, we herein introduce an unusual presentation. Our patient was an 86-year-old man with a primary presentation of typical chest pain in the setting of recently diagnosed coronary artery disease with concomitant Ebstein's anomaly. We found mild-to-moderate tricuspid regurgitation, bicuspid aortic valve, persistent left superior vena cava, and patent foramen ovale. The patient had suffered from chest discomfort on exertion for 2 months with good functional capacity prior to diagnosis. Coronary angiography revealed two-vessel disease. The patient refused surgery. He was treated with medical anti-ischemic therapy. He had good exercise tolerance with relief of chest pain at the latest follow-up. The features demonstrated in this case report suggest that there may be several adult survivors of complex congenital heart diseases requiring individualized surgical treatment plans.
埃布斯坦畸形的定义是三尖瓣显著向心尖移位导致三尖瓣反流。尽管此前已描述过多种伴随病变，但我们在此介绍一种不寻常的表现。我们的患者是一名86岁男性，最初表现为典型胸痛，近期诊断为冠状动脉疾病并伴有埃布斯坦畸形。我们发现有轻度至中度三尖瓣反流、二叶式主动脉瓣、永存左上腔静脉和卵圆孔未闭。患者在诊断前2个月就已出现劳力性胸部不适，但功能能力良好。冠状动脉造影显示双支血管病变。患者拒绝手术。他接受了抗缺血药物治疗。在最近一次随访时，他运动耐量良好，胸痛缓解。本病例报告中展示的特征表明，可能有多名复杂先天性心脏病成年幸存者需要个体化的手术治疗方案。
