Wednesday, November 9, 2016

Ebstein's Anomaly- A Congenital Heart Defect



Ebstein's anomaly is a rare congenital heart defect, in which the septal and posterior leaflets of the tricuspid valve are displaced towards the apex of the right ventricle of the heart.

Pathophysiology: The tricuspid valve is normally made of three parts, called leaflets or flaps. The leaflets open to allow blood to move from the right atrium (top chamber) to the right ventricle (bottom chamber) while the heart relaxes. They close to prevent blood from moving from the right ventricle to the right atrium while the heart pumps.

In persons with Ebstein anomaly, the leaflets are placed deep in the right ventricle instead of the normal position. The leaflets are often larger than normal. The defect most often causes the valve to work poorly, and blood may go the wrong way. Instead of flowing out to the lungs, the blood flows back into the right atrium. The backup of blood flow can lead to heart enlargement and fluid buildup in the body. There may be narrowing of the valve that leads to the lungs (pulmonary valve).

In many cases, patients also have a hole in the wall separating the heart's two upper chambers (atrial septal defect) and blood flow across this hole may cause oxygen-poor blood to go to the body. This can cause cyanosis, a blue tint to the skin caused by oxygen-poor blood.

Clinical Features: Mild forms of Ebstein's anomaly may not cause symptoms until later in adulthood. If signs and symptoms are present, they may include:
  • Shortness of breath, especially with exertion
  • Fatigue
  • Heart palpitations or abnormal heart rhythms (arrhythmias)
  • A bluish discoloration of the lips and skin caused by low oxygen (cyanosis)
Diagnosis: On history and physical examination if Ebstein anomaly is suspected following workup help in the diagnosis:

1. Echocardiogram: is often used to diagnose many of the congenital heart defects including Ebstein anomaly. 
2. Chest X ray: will reveal an enlarged heart (see picture above)
3. ECG: About 50% of individuals with Ebstein's anomaly have evidence of Wolff-Parkinson-White syndrome, secondary to the atrialized right ventricular tissue.
4. Cardiac MRI; may help determine the severity of the condition and give a detailed view of the tricuspid valve. 

Management: Treatment depends on the severity of the defect and the specific symptoms. Medical care may include:
  • Medications to help with heart failure, such as diuretics
  • Oxygen and other breathing support
  • Surgery to correct the valve
  • Replacement of the tricuspid valve. This may be needed for children who continue to worsen or who have more serious complications.

3 comments:

  1. Hello, my name is Betty. i was diagnosed of HIV virus 4 years back. Before then, i was dating this Derrick guy. we had something great going on. Our love life only lasted for 8 months. the sixth and seven month of our relationship, i began feeling very weak every now and then. But i never suspected anything until I kept on experiencing different symptoms like having sore throats, constant headache, body weakness e.t.c. I decided to go for a medical check up. I was tested HIV positive. when the doctor broke the news to me, it was as if my whole world had crumbled. it dawned on me then that Derrick has been lying to me. i was very mad to an extent i almost committed suicide. But there was nothing i could do, other than weep and weep. ever since then, i have been spending heavily on medications, going from one medical clinic or the other so I can look healthy. Though since i was a kid, i love herbs a lot. i take herbal tea with grandma while growing so i am quite familiar with herbs. early last year, i was on the internet and on a particular health blog, to check for herbal medication as alternative. I saw many comments and read many testimonies. Until i came across a particular testimony on how Dr.ugo cured a patient from herpes simplex virus using pure natural herbs. i reached out to the doctor because I also was thinking Herpes had no cure. I told him about my HIV status.He encouraged me not to panic that he will help me get my deliverance. he prepared some herbs and sent them to me. The herbs were in four 70ml bottles and I took them morning and night. i used as he directed, and in less than three weeks, i started having appetite to eat plenty of food and i gained back my strength. the fourth week,I consumed all the herbal meds. He encouraged me to go for a test which i did. This time, the result was negative. I quickly contacted the doctor and informed him of the news. I immediately asked him to prepare for Derrick too. He did and sent it. Today, me and Derrick are HIV free. All thanks goes to God Almighty for healing us through Dr.Ugo. if you are having any kind of sickness at all, Dr.Ugo is the right person to talk to and i assure you, you will be glad you did. His email: ugoherbalhome@gmail.com you can also write him on WhatsApp +2348104990619.

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  2. I feel so excited today because it's just a year since I got my breakthrough from Herpes.I was diagnosed of HSV1 on the 12/4/2015 and latter i got affected with the HSV2. That was my 2nd outbreak after i lost my ex fiance that got me affected with the virus. I was so scared when he died and what i heard about the Herpes virus as he's deathly and such has no cure. I feel so pity and and a disgrace to my personality,in my career and my family to have been in with the deathly sickness, and that would makes my love ones siblings stay far from me. I was going to my regular church activities when i begin to hear testimonies of how people get cure online, i never gave it a thought till my cousin Stephanie who was affected with HIV told me, Lenny you need not to worry cos i met i man today online , i traditional herbal healer whom two of her friends confirmed he cure them with his herbal herbs that i should give it a try. I saw the interest in her and she did contact the herbal doctor again in my present, luckily for me he picked and show up himself, behold he was at about to attain to some patients that have came back with appreciation of how he cure them from Cancer, HIV, and off much too the herpes he cured an 18 years old daughter.
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  3. I was diagnosed of herpes virus, I have tried all possible means to get cure but all my effort proved abortive, until a friend of mine introduced me to a herbal doctor called Dr Agaba, who prepare herbal medicine to cure all kind of diseases including herpes virus (Herpes), when i contacted this herbal doctor via email, he sent me herpes virus herbal medicine via courier service, when i received the herbal medicine he gave me step by step instructions on how to apply it, when i applied it as instructed i was totally cured from the virus within 3 weeks of usage. Contact this great herbal doctor today to get your cure. 
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