Ebstein's anomaly is not associated with which condition?

• A. Pulmonary stenosis
• B. Tricuspid regurgitation
• C. Atrial septal defect
• D. Right atrial enlargement

Answer: (A)

This question tests understanding of which conditions commonly accompany Ebstein’s anomaly. The key features of Ebstein’s anomaly are downward displacement of the septal and posterior tricuspid valve leaflets into the right ventricle, resulting in “atrialization” of part of the RV, a very large right atrium, and a small functional right ventricle. This setup leads to severe tricuspid regurgitation and marked right atrial enlargement. Because the problem centers on the tricuspid valve and right-heart geometry, interrelated findings frequently seen are a patent foramen ovale or an atrial septal defect (due to elevated right atrial pressures), and electrical conduction issues such as Wolff-Parkinson-White syndrome.

Pulmonary stenosis is not a typical association, since Ebstein’s anomaly affects the tricuspid valve and right heart inflow/outflow mechanics rather than the pulmonary outflow tract itself. Conditions with pulmonary outflow obstruction, like pulmonary stenosis, represent a different subset of congenital heart disease.

So, pulmonary stenosis is not commonly linked with Ebstein’s anomaly.