Endomyocardial Fibrosis Associated With Myocardial Infarction

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Pathology

Background:

• Endomyocardial fibrosis (EMF) is a primary cause of restrictive cardiomyopathy in tropical regions.
• It is characterized by fibrosis of the subendocardium, leading to diastolic dysfunction.
• EMF diagnosis can be challenging, often requiring multimodality imaging.

Observation:

• A 55-year-old male presented with an anterior myocardial infarction.
• Imaging revealed left ventricular apical obliteration, apical thrombus, and subendocardial fibrosis.
• The patient had restrictive physiology without significant systolic dysfunction.

Findings:

• The findings were consistent with Endomyocardial fibrosis (EMF).
• Cardiac magnetic resonance imaging demonstrated characteristic scar patterns.
• Differential diagnoses included apical hypertrophic cardiomyopathy and left ventricular thrombosis.

Implications:

• EMF should be considered in patients with heart failure and thrombotic events.
• Multimodality imaging, particularly cardiac MRI, is crucial for diagnosis.
• Early recognition of EMF can guide appropriate management and improve patient outcomes.