Ebstein’s Anomaly Associated with Atrial Septal Defect Revealed by Palpitations: A Case Report

Background: Ebstein’s anomaly is a rare congenital malformation of the tricuspid valve, frequently associated with atrial septal defect and atrial arrhythmias. Adult presentation is uncommon and often revealed by palpitations. Case summary: We report the case of a 21-year-old woman with no cardiovascular risk factors who presented with recurrent palpitations. Clinical examination revealed mild cyanosis and hypotension. Electrocardiography showed right atrial hypertrophy and complete right bundle branch block. Chest X-ray demonstrated massive cardiomegaly with a characteristic “rugby ball” appearance. Transthoracic echocardiography confirmed Ebstein’s anomaly with severe apical displacement of the tricuspid valve and associated atrial septal defect. Holter monitoring revealed non-sustained atrial tachycardia. The patient improved clinically under beta-blocker and anticoagulant therapy with regular rhythmology follow-up. Conclusion: Ebstein’s anomaly may remain asymptomatic until adulthood and may present with atrial arrhythmias. Echocardiography remains the cornerstone of diagnosis, and early management is essential to prevent complications.