Which findings are commonly seen with Ebstein's anomaly?

• A. Patent foramen ovale (PFO) and ASD
• B. VSD and PDA
• C. Coarctation
• D. Tetralogy of Fallot

Answer: (A)

Ebstein's anomaly causes downward displacement of the tricuspid valve with a large, atrialized portion of the right ventricle, leading to right atrial enlargement and tricuspid regurgitation. The big right atrium and altered pressures make interatrial communications like a patent foramen ovale or an atrial septal defect common findings, since these openings permit shunting between the atria and can persist or become clinically evident with the abnormal right-sided pressures. Other defects such as VSD with PDA, coarctation, or Tetralogy of Fallot are not characteristically linked to Ebstein's anomaly, so the combination most often seen is PFO and ASD.