Lithium-induced Ebstein's Anomaly

Abstract

Ebstein's anomaly (EA) is a rare congenital cardiac defect that occurs when the tricuspid valve leaflets fail to delaminate from the ventricular myocardium, they adhere to the underlying myocardium. Multiple etiologies such as genetic mutation in NKX2-5, family history of congenital cardiac anomalies, and exposure to teratogen such as lithium are associated with this rare cardiac anomaly. In our case, we present an undiagnosed adolescent male with EA who was exposed to lithium during organogenesis.

Keywords: Antenatal care; Ebstein’s anomaly; atrialization of right ventricle; congenital cardiac defect; lithium.

Figure 1

Two-dimensional echocardiography showing a hugely dilated right atrium with an area of 33.5 cm²

Figure 2

Two-dimensional echocardiography showing four chamber view

Figure 3

Two-dimensional echocardiography showing apical displacement of the septal tricuspid leaflet by 18 mm² and flail anterior tricuspid leaflet