Early angiographic features of right ventricular endomyocardial fibrosis

Right ventricular (RV) angiograms were done in 45 patients with left ventricular (LV) endomyocardial fibrosis (EMF). 34 patients had angiographic features compatible with the diagnosis of RV and LV EMF. 11 patients showed the angiographic features of EMF on the left side, but did not show the classical angiographic features on the right side. The RV angiograms of these 11 patients showed a disturbance of the normal parenchymal pattern along the septal margin, irregular small filling defects near the apex and the septal region and minimal tricuspid regurgitation. Biopsies from the RV taken from 2 of these patients during operation for mitral valve replacement had histological features compatible with the diagnosis of EMF on the right side also. This study demonstrates that the early angiographic features of RV EMF differ from those of well-established cases already described in the literature, and that it is possible to spot RV EMF well before the conventional features appear in RV angiograms.