A child presents with a rare cyanotic congenital hea disease with diminished pulmonary blood flow due to an abnormality of tricuspid valve. Which of the following is found in this cardiac condition?

This patient is suffering from Ebstein's anomaly which is a cyanotic congenital hea disease resulting from diminished pulmonary blood flow due to an abnormality of tricuspid valve. In this condition right atrium dilates because the abnormal tricuspid valve prevents the forward flow of blood as well as cause regurgitation of blood from right ventricle into right atrium. Ebstein's anomaly: Patients presents with history of cyanosis, effo intolerance and fatigue. JVP shows dominant V wave. ECG shows P pulmonale as well as P mitrale and right bundle branch block. R wave in V1 does not exceed 7mm, lead V6 shows a relatively tall R wave as well as broad S wave. Xray shows cardiac enlargement. Prominent main pulmonary aery segment, small aoic knuckle and diminished pulmonary vasculature. Ref: Essential Paediatrics By O P Ghai, 6th edn, page 410-1.