Differential Diagnosis
- Single most likely diagnosis
- Ebstein's anomaly: This congenital heart defect is characterized by the apical displacement of the tricuspid valve, dilation of the right atrium, and often associated with right heart border prominence on chest radiograph, which matches the patient's presentation.
- Other Likely diagnoses
- Tricuspid regurgitation: This condition could lead to right atrial dilation and symptoms of dyspnea, fatigue, and palpitations, although the apical displacement of the tricuspid valve is more specific for Ebstein's anomaly.
- Cardiomyopathy (e.g., dilated cardiomyopathy): While cardiomyopathy could explain the cardiomegaly and symptoms, the specific echocardiographic finding of apical displacement of the tricuspid valve points more towards Ebstein's anomaly.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: Although less likely given the chronic nature of symptoms and the specific echocardiographic findings, pulmonary embolism can cause sudden onset of dyspnea, fatigue, and palpitations, and is a potentially life-threatening condition that requires immediate attention.
- Cardiac tamponade: This condition, characterized by fluid accumulation in the pericardial space, can lead to cardiomegaly on chest radiograph and symptoms of dyspnea and fatigue, but typically presents with more acute symptoms and specific echocardiographic signs of tamponade.
- Rare diagnoses
- Uhl's anomaly: A rare congenital heart defect characterized by a nearly total absence of the myocardium of the right ventricle, which could present with similar symptoms and right heart dilation, but is much less common than Ebstein's anomaly.
- Arrhythmogenic right ventricular cardiomyopathy (ARVC): A rare condition that affects the right ventricle and can lead to symptoms of palpitations and dyspnea, but typically has different echocardiographic characteristics and often presents with arrhythmic symptoms.