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A Challenging Differential Diagnosis: Distinguishing between Endomyocardial Fibrosis and Apical Hypertrophic

Cintia Prado Maia1, Luís Gustavo Gali1, André Schmidt1

  • 1Internal Medical Department, Cardiology Center, Medicine School of Ribeirão Preto, São Paulo University, Ribeirão Preto, Brazil.

Echocardiography (Mount Kisco, N.Y.)
|May 5, 2016
PubMed

Insights

Endomyocardial fibrosis, a cause of restrictive cardiomyopathy, involves fibrous tissue deposition in ventricles. Cardiac imaging is crucial for distinguishing it from apical hypertrophy, especially in complex cases.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging

Background:

  • Endomyocardial fibrosis (EMF) causes restrictive cardiomyopathy, predominantly in tropical regions.
  • It affects ventricular diastolic function and atrioventricular valves, with varied clinical presentations.

Observation:

  • A challenging case presented with indeterminate echocardiographic findings suggestive of apical hypertrophy.
  • The patient also had severe aortic stenosis and left ventricular outflow tract fibrosis.

Findings:

  • Electrocardiogram showed symmetrical T-wave inversion, a sign of apical hypertrophy.
  • Cardiac imaging, including echocardiography and MRI, proved vital in differentiating EMF from apical hypertrophy.

Implications:

  • Accurate differentiation between EMF and apical hypertrophy is critical for appropriate patient management.
  • This case underscores the diagnostic utility of advanced cardiac imaging in complex cardiovascular conditions.

Keywords:
cardiac magnetic resonanceechocardiographyendomyocardial fibrosisrestrictive cardiomyopathy

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