Recurrent Transient IscRecurrent Transient Ischemic Attacks in a 48-Year-Old Patient With an Undiagnosed Ebstein’s Anomaly: A Case Report

Nuno Correia, Ana Caló, Guilherme Gama, Luísa Fonseca, Goreti Moreira


Ebstein’s anomaly is a rare congenital malformation of the heart characterized by apical displacement of the septal and posterior tricuspid valve leaflets, leading to atrialisation of the right ventricle with a variable degree of malformation and displacement of the anterior leaflet. Its presentation depends on the severity of the anomaly. Mild forms are often undiagnosed until adulthood due to its benign course. Importantly, interatrial communications are present in 80% of the patients with EA through which a paradoxical embolism may occur whenever a right-to-left shunt exists. The authors describe a case of a 47-year-old white man that presented with acute recurrent transitory ischemic brain attacks and progressive exertional dyspnea. A brain CT scan revealed infarcts in multiple vascular territories. Echocardiographic studies revealed an Ebstein’s anomaly with a right-to-left shunt through an interatrial communication and severe right heart failure. Doppler study of the cervical and extremities’ vessels was negative for a possible thrombotic source. A diagnosis of transient ischemic attacks presumably secondary to paradoxical embolism with unknown source was established. The patient was successfully submitted to heart surgery and improvement of symptoms and heart function was observed. At follow-up he remains well and without further neurological events.

J Med Cases. 2012;3(1):54-59


Ebstein’s anomaly; Interatrial communication; Paradoxical embolism; Transient ischemic attacks

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.