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IN PRESS
Ebstein’s Anomaly: An Unanticipated Differential Diagnosis of Egg-on-Stick Appearance and the Diagnostic Dilemma

Hayatu Umar, Usman Muawiyya Zagga, Femi Akindotun Akintomide, Abubakar S. Maiyaki, Musa Tambuwal Umar, Nasiru Altine Dankiri, Shamsuddeen Yusuf

Nigeria Department of Internal Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Am J Case Rep 2021; 22:e924810 :: DOI: 10.12659/AJCR.924810

Available online: 2021-02-01, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication.
The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

#924810

BACKGROUND Ebstein’s anomaly (EA) is a rare congenital cardiac abnormality with diverse anatomic and spectra of clinical presentations. This heart anomaly occurs in approximately 1 per 200 000 live births and accounts for <1% of congenital cardiac diseases. The main pathologic finding is “atrialization” of the basal region of the right ventricle. EA has been described extensively in the literature; however, to the best of our knowledge, this is the first reported case of EA presenting with ”egg-on-stick” appearance.
CASE REPORT A 42-year-old woman presented on account of 2 years of progressive abdominal swelling, early satiety, and progressive weight loss. There was an associated history of dyspnea on exertion, easy fatigability, paroxysmal nocturnal dyspnea, and orthopnea. General examination revealed egg-on-stick appearance: visible distended abdominal wall veins and massive ascites with no pedal edema. Overall, pertinent cardiovascular examination findings and echocardiographic features are in keeping with EA.
CONCLUSIONS We present the likely first case of egg-on-stick appearance as part of the presentation of EA, which posed a diagnostic dilemma. Echocardiography can help in unraveling this dilemma.

Keywords: Diagnosis, Differential; Ebstein Anomaly; Echocardiography

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