Left ventricle endomyocardial fibrosis: a case report.

Area of Science:

• Cardiology
• Cardiovascular Pathology
• Restrictive Cardiomyopathy

Background:

• Endomyocardial fibrosis (EMF) is the most prevalent restrictive cardiomyopathy globally, with unknown etiology and pathogenesis.
• EMF is linked to chronic eosinophilia and potential dietary, environmental, and infectious triggers, causing inflammation and myocardial damage.
• The condition leads to fibrotic obliteration of ventricles, causing restrictive physiology and often affecting mitral valve function, predominantly in tropical regions.

Observation:

• A 67-year-old male with a history of schistosomiasis presented with progressive dyspnea, edema, and weakness.
• Echocardiography and cardiac MRI revealed significant left ventricular apical obliteration, thickened walls, mitral regurgitation, and an apical thrombus.
• The patient underwent mitral valve replacement, endocardial decortication, endomyocardiectomy, and coronary artery bypass grafting.

Findings:

• Surgical intervention for endomyocardial fibrosis resulted in an uncomplicated postoperative course.
• The patient achieved New York Heart Association functional class I six months post-surgery, indicating significant recovery.
• Advanced imaging techniques were crucial for diagnosing the extent of myocardial fibrosis and associated complications.

Implications:

• This case underscores the importance of multidisciplinary approaches in managing complex cardiovascular diseases like endomyocardial fibrosis.
• Improvements in diagnostic imaging and surgical techniques enhance patient survival and quality of life for those with restrictive cardiomyopathies.
• Further research into the etiology and pathogenesis of endomyocardial fibrosis is warranted to improve preventative strategies.