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Anaesthetic management of emergency lower segment caesarean section in a patient with Ebstein's anomaly

Ebstein’s anomaly was described by Wilhelm Ebstein in 1866.[1] It is characterised by tricuspid regurgitation, due to dysplastic abnormalities of the tricuspid valve, an atrialised, thin walled and poorly contractile proximal part of the right ventricle and an enlarged right atrium.[2] Disease severity depends on the degree of valvular abnormality, presence of patent foramen ovale with intracardiac shunt, pulmonary hypertension, cardiac dysrhythmias and association with Wolff–Parkinson–White syndrome (up to 20% of patients).[2,3] Clinical presentation varies from congestive cardiac failure (CCF) in childhood to incidental diagnosis in adulthood.