Inferior Wall Myocardial Infarction Haemodynamically Complicated by Associated Ebstein Anomaly

Ebstein's anomaly is an uncommon cardiac malformation affecting tricuspid valve and right ventricle. We report aware case of previously asymptomatic undiagnosed Ebstein anomaly presenting with decompensated haemodynamic status and cyanosis due to acute inferior wall myocardial infarction. Following aspects of this case makes it a rare presentation. Firstly, the unusual presentation of Ebstein anomaly as inferior wall myocardial infarction and atrio-ventricular dissociation. Secondly, the long asymptomatic period with two successfully completed pregnancies. Thirdly, particularly only right coronary artery involvement in Ebstein anomaly in this as well as previously reported 3 cases. Fourthly, coexistence of Ebstein anomaly with inferior wall myocardial infarction which lead to acute haemodynamic compromise and cyanosis. Lastly, this highlights the importance of early revascularization to salvage myocardium in already congenitally thin and fibrosed ventricles in Ebstein anomaly.