A profile of endomyocardial fibrosis

Abstract

EMF is a restrictive cardiomyopathy of tropics and has its onset in children and young adults who belong to the poorer strata of society. Physical signs in patients are dominated by features of congestive heart failure. While two dimensional echo has contributed great deal to the diagnosis of EMF, selective cardiac angiography remains the method of choice for detailed demonstration of the anatomical lesions and their progression. Morphologic characteristic of the disease is severe endocardial collagenous thickening with degenerative changes in subendocardial myofibres. Aetiopathogenesis of the disease is yet to be elucidated. Recent studies suggest a role for magnesium deficiency and chronic ingestion of toxic elements of monazite sands. Medical approach to treatment is based on decongestive therapy which provide partial relief from symptoms of congestive heart failure. Endocardiectomy and valve replacement which offer immediate haemodynamic improvement and increase the survival rate of patients have an important role in the management of EMF.