When we hear of any 'heart disease', high blood pressure or chest pain often come to mind. But what if your lips were quietly warning of an undiagnosed, life-threatening heart condition? A rare congenital defect called Ebstein’s anomaly may do just that—and many people don’t even realize it.This congenital defect in the heart may go undetected for years, until a small indication such as blue or greyish tinting of the lips or nails indicates something much more critical: your blood may be circulating in the wrong direction inside your heart. Our bodies tend to communicate with us in soft, subtle language. A hint of blue in your lips, unexplained fatigue, or difficulty breathing could be more than just everyday exhaustion—they may be clues pointing to a serious underlying heart condition.What Is Ebstein’s Anomaly?Ebstein's anomaly is a rare congenital heart defect—i.e., it exists at birth. It occurs in about one out of every 200,000 live births and represents fewer than 1% of all congenital heart defects. Although rare, it is a serious condition that needs to be monitored closely and treated.The condition mostly influences the tricuspid valve, which is among the four heart valves that govern blood circulation into and out of the heart. In a normal heart, the tricuspid valve directs the blood in the right direction from the right atrium to the right ventricle. The valve in persons with Ebstein's anomaly is deformed and fails to seal correctly, making it possible for blood to pass backward—a situation referred to as regurgitation.This reversed flow can enlarge the upper chamber (right atrium) and shrink and weaken the lower chamber (right ventricle), decreasing the efficiency of the heart. In the long run, this extra workload may result in heart failure, provided it is not treated.Symptoms of Ebstein's AnomalyAlthough most individuals with Ebstein's anomaly have no symptoms during childhood, others become aware of the condition years after it occurred—usually during tests for irregular heart rhythms or difficulty breathing on exertion.One of the most subtle yet revealing symptoms? Blue or grey discoloration on the lips and fingernails, which is known as cyanosis. It's a sign of inadequate oxygen flow—meaning not enough oxygenated blood is being efficiently pumped around the body.What is more concerning is that such discoloration may be less apparent on darker-skinned individuals, so early detection is even more difficult. In most instances, these symptoms are overlooked or blamed on other factors such as cold or tiredness.Why Is Ebstein's Anomaly Often Misdiagnosed or Missed?Even with warning signs, Ebstein's anomaly can be overlooked, particularly in people with less severe forms of the condition. Since many of the symptoms are nonspecific—such as fatigue, dizziness, or palpitations—they can be attributed to stress, anxiety, or lifestyle issues.It is sometimes identified in babies at birth during routine tests, particularly if a heart murmur is heard. A murmur is a whooshing noise caused by turbulent blood flow through the heart, usually picked up by an examining physician with a stethoscope.Most adults do not receive a diagnosis until much later, usually while being screened for atrial septal defects (ASD) or patent foramen ovale (PFO)—both of which occur commonly in conjunction with Ebstein's anomaly.Risks of Untreated Ebstein's AnomalyIf left untreated or undiagnosed, Ebstein's anomaly can cause severe complications, such as:Enlargement and weakening of the heartHeart rhythm disturbances (arrhythmias)Increasing heart failureStroke or blood clotting due to pooling of bloodThe British Heart Foundation alerts that the reversed flow of blood can put severe wear and tear on the heart muscle over time, causing worsening cardiac function and potentially fatal consequences.Is there a Treatment for Ebstein's Anomaly?Treatment of Ebstein's anomaly is based on several factors, such as the severity of the malformation, whether there are symptoms, and associated heart disease. Mild cases might only require follow-up and medication, whereas severe presentations might necessitate surgical correction or valve replacement.In certain instances, catheter-based interventions can be employed to fix irregular heart rhythms or seal accompanying defects. More complicated cases might involve open-heart surgery, and in extreme situations, heart transplantation is an option.More sophisticated treatment regimens now also encompass dual immunotherapy regimens and targeted radiotherapy, particularly for patients who could be diagnosed later in life with added complications.With growing awareness of such unusual congenital cardiac anomalies as Ebstein's anomaly, it is all the more imperative that those affected—and their doctors—take careful notice of these symptoms, particularly if they increase or persist over time.If you or someone close to you notice symptoms of bluish coloration around the lips, palpitations, or abnormal breathlessness, have a detailed cardiac assessment undertaken. Quick detection and intervention can make all the difference in overall well-being and quality of life down the road.