Controversies and advances in endomyocardial fibrosis: a review

Controversial aspects of, and recent advances in endomyocardial fibrosis are reviewed. Available data indicate that the disease has a worldwide distribution but is most prevalent in tropical Africa. Several factors have been incriminated in different parts of the world in its aetiopathogenesis but in tropical Africa subclinical viral myocarditis and eosinophilia caused by parasitic infections appear to be the most likely causes. Despite diversity in its aetiology, however, the clinicopathological manifestations are fairly uniform. This has facilitated the recognition of characteristic electrocardiographic and echocardiographic signs as well as the use of similar surgical techniques for its treatment in different countries.