Endomyocardial fibrosis (EMF) is a disorder of uncertain etiology that can affect the left, right or both ventricles.


Pathology: subendocardial fibrosis of the left ventricle


Pathologic changes:

(1) restrictive cardiomyopathy

(2) mitral valve regurgitation (due to tethering of the papillary muscles)

(3) left atrial enlargement


Clinical features of left ventricular endomyocardial fibrosis (LVEMF):

(1) diastolic dysfunction of the left ventricle

(2) absence of ascites

(3) pulmonary edema

(4) variable progression to pulmonary hypertension

(5) atrial fibrillation often with fast ventricular response


Complications may include thrombus formation in the left ventricle or left atrium with cerebral and peripheral emboli.


The diagnosis can be made by echocardiography or cardiac imaging method, which demonstrates the subendocardial fibrosis and mitral valve changes. Endocardial calcification may occur.


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