This case shows Ebstein anomaly with tricuspid regurgitation in an elderly patient.  The anomaly was also demonstrated on echocardiography. Ebstein anomaly occurs in about 1 of every 200,000 live births and initial presentation by older patients is rare, as only 5% survive beyond the fifth decade. Patients often have symptoms associated with heart failure due to the dilated and atrialized right ventricle compressing the left ventricle and, additionally, reducing preload for the left heart.