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Radiology
Ebstein Anomaly and Tricuspid Dysplasia
Built from Obstetric Imaging
What’s inside
11 sections · 62 slides
Overview
- What this covers
The valve at the centre of it all
Normal anatomy first, then the two ways it goes wrong
- Where the tricuspid valve sits
- Why the attachment level matters
- Ebstein anomaly: the door has slipped down
- Part of the pump joins the collecting chamber
- Tricuspid dysplasia: the door is in place but badly built
- The one question that names the disease
- Different anatomy, the same trouble
How often, and why they happen
Rare defects with a low chromosomal risk but frequent cardiac company
- 1–5
- What causes them
- The company they keep
- Displaced tricuspid valve in a specimen and on echocardiography
How these babies present
A neonatal form and an adult form, at two ends of one spectrum
- Two ways the disease shows itself
- More than a valve problem
- Why the milder cases quieten down
Finding Ebstein anomaly on ultrasound
Six things to look for, all starting from the four-chamber view
- One view does most of the work
- The key diagnostic feature
- Tricuspid valve sitting lower than the mitral valve
- Apical four-chamber view, enlarged
- How far down counts as displaced?
- The valve itself looks wrong
- The leak, and how it is measured
- Colour Doppler through the leaking valve
- Where the leaking jet is born in Ebstein anomaly
- The heart gets big
- A small right ventricle
- Check the exit to the lungs
- A real blockage, or just no forward push?
- How one displaced valve wrecks the right heart
Finding tricuspid dysplasia
Almost the same picture, decided by where the jet starts
- What changes, and what stays the same
- Normally attached but dysplastic tricuspid valve
- A leaking jet that starts at the valve ring
- The deciding sign: where the jet begins
- Chamber sizes tell them apart too
- Dysplasia and the outflow to the lungs
- Doppler signature of a badly leaking tricuspid valve
- One more tool when the view is unclear
Classic signs, as a checklist
What to write in the report, view by view
- Signs shared by both, on the four-chamber view
- Signs that separate them
- Signs in the outflow views
- Working through the scan
Two look-alikes
Conditions that copy the picture and how to unmask them
- Pulmonary atresia with an intact ventricular septum
- Early narrowing or closure of the arterial duct
- <2.0
Care before birth
What to rule out, how often to rescan, what to expect
- First steps once the diagnosis is made
- What every follow-up scan checks
- Why those checks matter
- The fetal shunts checked at every follow-up scan
- 15–25%
- Reading those numbers
- Planning the delivery
Care after birth
Complex early surgery at one end, a quiet childhood at the other
- The severe newborn with Ebstein anomaly
- What the palliative repair involves
- The moderate case
- Tricuspid dysplasia after birth
Take-home
What to tell the referring physician, and what to remember
- What the referring physician needs to know
- What the referring physician needs to know
- Key points
- “
- References
- References (continued)
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition