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Updated: Jun 17, 2026
09:37
Permanent Ligation of the Left Anterior Descending Coronary Artery in Mice: A Model of Post-myocardial Infarction Remodelling and Heart Failure
Published on: December 2, 2014
[Endomyocardial fibrosis causing right intraventricular gradient and obliteration]
Gülten Taçoy1, Yusuf Tavil, Adnan Abaci
1Department of Cardiology, Medicine Faculty of Gazi University, Ankara, Turkey. gtacoy@gmail.com
Summary
Endomyocardial fibrosis can cause restrictive cardiomyopathy, presenting as right ventricular tissue growth. This case highlights how it can mimic idiopathic pulmonary hypertension, emphasizing accurate diagnosis and management.
Area of Science:
- Cardiology
- Cardiovascular Pathology
Background:
- Endomyocardial fibrosis (EMF) is a primary restrictive cardiomyopathy prevalent in tropical regions, often affecting younger individuals.
- It is characterized by fibrosis of the endocardium, primarily impacting the atria and ventricles.
Observation:
- A 19-year-old male presented with lower extremity edema and fatigue, symptoms suggestive of heart failure.
- Echocardiography revealed dilated right heart chambers, left ventricular restrictive physiology, and significant right ventricular inflow tract tissue growth causing a 60-mmHg gradient.
- MRI confirmed the abnormal tissue formation in the right ventricle.
Findings:
- The right ventricular inflow tract obstruction due to tissue growth led to a significant pressure gradient, mimicking pulmonary hypertension.
- Medical management resulted in symptom resolution and functional improvement (NYHA Class II).
- Surgical intervention was deemed high-risk and unnecessary given the patient's response to medical therapy.
Implications:
- This case underscores the importance of considering EMF in the differential diagnosis of right heart conditions, especially in endemic areas.
- Misdiagnosis as idiopathic pulmonary hypertension can occur due to the RV pressure gradient, necessitating comprehensive cardiac imaging and evaluation.
- Conservative management may be effective for EMF with right ventricular involvement when symptoms resolve and surgical risks are high.
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