A case of diffuse endomyocardial fibrosis of the right ventricle with persistent pericardial effusion

A case of 42-year-old female with persistent pericardial effusion and recurrent congestive heart failure was presented. The clinical course, laboratory and cardiac evaluations confirmed the existence of tricuspid incompetence and restrictive condition of the right ventricle. At autopsy, the right atrium and ventricle showed moderate hypertrophy, the left ventricle being almost completely spared macroscopically. Diffuse fibrous thickening of the right atrial and ventricular endomyocardium with mural thrombi, and mild lymphocytic infiltation were noted microscopically. These findings are compatible with endomyocardial fibrosis described by Davies. The etiology and pathogenesis of the disease were discussed.