The absence of significant precordial pulsation on visualization is seen in Ebstein syndrome, with an inflated and quiet precordial area with no significant precordial pulsation on visualization. Ebstein syndrome, also known as Ebstein malformation, is a condition in which the tricuspid septal and/or posterior valves occasionally attach to the right ventricular wall near the apex along with the anterior valve downward about 0.5% to 1.0% of precardiac disease. This is a rare disease, first reported by Ebstein in 1866. This disease is also known as tricuspid inferior valve malformation. Occasionally, there is a family history, and offspring of mothers taking lithium early in pregnancy are susceptible to this disease. In the functional right ventricle, systolic pressure may be normal, while diastolic pressure is often increased, similar to constrictive pericarditis. Both systolic and diastolic pressures are elevated in the atrial chambers. There may be a systolic pressure difference on both sides of the pulmonary valve and a diastolic pressure difference on both sides of the tricuspid valve. The former may be due to an overgrown tricuspid leaflet that partially obstructs the right ventricular outflow tract; the latter is due to tricuspid valve malformation and tricuspid orifice stenosis. How to check for the absence of significant precordial pulsation by visualization? It can be seen in Ebstein’s syndrome, the onset of which can be early or late and the symptoms can be mild or severe and the signs can be varied. In severe malformations, cyanosis and congestive heart failure are evident from birth; in milder malformations, the most prominent symptoms of the malformation are cyanosis and congestive heart failure until adulthood. The main signs of Ebstein’s syndrome include: a bulging and quiet precordial region (no significant precordial pulsation on visualization and no sense of pulmonary artery closure on palpation); a marked splitting of the first and second heart sounds, an enhanced third heart sound, and a fourth heart sound; the second component of the split first heart sound is often karate in nature, which is known as the sailsign sign; a soft A soft systolic murmur and a short mid-diastolic murmur may be present in the tricuspid region. According to Siber, the two most characteristic signs for this malformation are: (1) cyanosis with a quiet precordial area; and (2) a quartet of 1st heart sounds, split 2nd heart sounds, and augmented 3rd or 4th heart sounds. Complications such as heart failure, arrhythmias, cerebral embolism and brain abscess can be combined.