title: Paradoxical embolism associated with Ebstein's anomaly in an adult: case report.
abstract: Ebstein's anomaly (EA) is a rare congenital malformation of the tricuspid valve, often associated with other cardiac malformations, especially atrial septal defect, which is present in 80-90% of patients and predisposes to paradoxical embolization. We describe the case of a 47-year-old male, a drug abuser, with a known but not investigated cardiac murmur. He presented to the emergency department with worsening exertional dyspnea and fatigue associated with recent recurrent transient ischemic attacks. On brain computed tomography there were multiple non-recent ischemic infarctions. Transthoracic echocardiography showed EA with severely dilated right cardiac chambers, right systolic dysfunction and severe tricuspid regurgitation. Contrast and transesophageal echocardiography revealed a patent foramen ovale with right-to-left shunt. After exclusion of other potential causes of the neurologic events, they were assumed to be the consequence of paradoxical embolism.
authors: Serviço de Cardiologia, Centro Hospitalar São João, Porto, Portugal. Electronic address: filipamelao@gmail.com.
authors: Filipa
authors: F
authors: Melão
authors: Serviço de Cardiologia, Centro Hospitalar São João, Porto, Portugal.
authors: Ana Sofia
authors: AS
authors: Correia
authors: Serviço de Cardiologia, Centro Hospitalar São João, Porto, Portugal.
authors: Maria Júlia
authors: MJ
authors: Maciel
mesh_terms: D004437:Ebstein Anomaly / Q000150:complications*; D019320:Embolism, Paradoxical / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Anomalia de Ebstein; Ebstein's anomaly; Embolismo paradoxal; Foramen oval patente; Paradoxical embolism; Patent foramen ovale