A Rare Presentation with Angina and Pseudoinfarct ECG Pattern in A Patient with Severe Form Ebstein's Anomaly

Abstract

We are presenting a rare case of an elderly female who had been asymptomatic until the age of 56 years and had successfully completed three pregnancies. She presented with an episode of acute onset chest pain of moderate intensity and was initially suspected to have an evolved inferior wall myocardial infarction on the basis of the electrocardiogram. The echocardiogram performed subsequently surprisingly revealed the presence of a severe form of Ebstein`s anomaly. Various forms of electrocardiographic abnormalities and conduction defects are reported in Ebstein’s anomaly but the presence of a normal ECG pattern or pseudoinfarct pattern with the absence of any associated conduction blocks or axis deviation is highly unlikely especially in severe forms of the disease. There are three aspects of this cases which make it rare. Firstly, the presentation of a patient with severe form of Ebstein`s anomaly with an isolated evolved inferior wall myocardial infarction pattern on the ECG ,secondly the presence of an extra-ordinarily long asymptomatic period and thirdly the presentation with angina as the presenting symptom with normal epicardial coronaries