Description
A 60-year-old woman initially presented 8 years ago with atypical chest pain and palpitations. Her 12-lead ECG demonstrated complete heart block, following which she underwent dual-chamber pacemaker implantation. She also had transthoracic echocardiogram, which was felt to be technically difficult due to body habitus. She was diagnosed to have mild mitral valve regurgitation, due to mild mitral valve prolapse, and was kept under annual surveillance. There was no other significant medical history. Her last TTE was done a year ago and she had been symptom-free up to her recent clinic visit. Her repeat TTE showed apically displaced Ebstein-like left atrioventricular valve (AV) with tricuspid valve morphology (confirmed by three-dimensional (3D) echo) and heavily trabeculated morphologically right ventricle on the left side of the heart (figures 1, 2, 3 and 4, online and ). Her systemic ventricle was mild to moderately impaired, and the tricuspid, left AV was moderately regurgitant. There are no obvious shunt and no...
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