case_images: PMC11732273_01
case_images: 1: Transthoracic echocardiographic apical view in enddiastole, a: without colour Doppler, b: with colour Doppler on the tricuspid valve showing only mild regurgitation. 2: Transoesophageal echocardiographic views of the quadricuspid aortic valve, a: plane view, showing four equal-sized cusps, Hurwitz & Roberts Type A or Nakamura Typ I, valve closed, b: valve open. 3: Magnetic resonance imaging, a: endsystolic four-chamber view, b: plane view of the quadricuspid aortic valve. 4: Coronary angiography, a: left coronary artery without a circumflex coronary artery, b: large right coronary artery. 5: Electrocardiogram (ECG) on admission with sinus bradycardia and left bundle branch block, heart rate 47/min. 6: Long-term ECG by the referring physician with asystole of 3.5 s with most likely AV block III. Arrow with double tip indicates apical displacement of the tricuspid valve. IAS, interatrial septum; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.
case_images: ytae680f1.jpg
case_images: PMC11732273_01_ytae680f1.jpg
case_images: ytae680-F1
case_images: Cardiac MRI confirmed Ebstein's anomaly (EA) with a 2.6-cm apical displacement and the QAV without any further malformation (Figure 1).