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. 1983 Mar;59(689):162–169. doi: 10.1136/pgmj.59.689.162

Endomyocardial disease in South America--report on 23 cases in Venezuela.

J J Puigbo, I Combellas, H Acquatella, I Marsiglia, F Tortoledo, H Casal, J A Suarez
PMCID: PMC2417453  PMID: 6844201

Abstract

Twenty-three cases of endomyocardial disease (ED) are presented, studied in Venezuela, a tropical country in northern South America. The diagnosis was confirmed in 18 cases by means of pathological studies, and in 5 cases by angiocardiography which showed the characteristic obliterative ventricular lesions. Eosinophilia was present in 35% of the patients. The most frequent clinical feature was heart failure associated with mitral regurgitation. Systemic embolism was the first clinical feature in 5 cases. In 2 cases, ED was associated with autoimmune haemolytic anaemia or vasculitis. Necropsy revealed a predominance of the left-sided (9/16 cases) and biventricular (6/16 cases) types. The pathological lesions were characterised by fibrous thickening of the endocardium at the apex and the ventricular inflow tracts extending to the myocardium and involving the atrioventricular valves. ED is frequently misdiagnosed as rheumatic valvular cardiopathy. The two-dimensional echocardiogram is a very useful procedure for determining the spatial anatomy of ED. The echo findings were closely correlated with ventriculographic and necropsy findings. Even though ED is widely spread around the world, it is most frequently found in tropical and subtropical countries in Africa, Asia and America, such as Venezuela and Brazil. This suggests that there are aetiological factors in these latitudes, about which little is known.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ANDRADE Z. A., GUIMARAES A. C. ENDOMYOCARDIAL FIBROSIS IN BAHIA, BRAZIL. Br Heart J. 1964 Nov;26:813–820. doi: 10.1136/hrt.26.6.813. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Acquatella H., Puigbó J. J., Suarez C., Mendoza J. Sudden early diastolic anterior movement of the septum in endomyocardial fibrosis. Circulation. 1979 Apr;59(4):847–848. doi: 10.1161/01.cir.59.4.847. [DOI] [PubMed] [Google Scholar]
  3. Andy J. J., Bishara F. F., Soyinka O. O. Relation of severe eosinophilia and microfilariasis to chronic African endomyocardial fibrosis. Br Heart J. 1981 Jun;45(6):672–680. doi: 10.1136/hrt.45.6.672. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Brockington I. F., Olsen E. G. Eosinophilia and endomyocardial fibrosis. Postgrad Med J. 1972 Dec;48(566):740–741. doi: 10.1136/pgmj.48.566.740. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Brockington I. F., Olsen E. G., Goodwin J. F. Endomyocardial fibrosis in Europeans resident in tropical Africa. Lancet. 1967 Mar 18;1(7490):583–588. doi: 10.1016/s0140-6736(67)90440-0. [DOI] [PubMed] [Google Scholar]
  6. CORREA P., RESTREPO C., GARCIA C., QUIROZ A. C. PATHOLOGY OF HEART DISEASES OF UNDETERMINED ETIOLOGY WHICH OCCUR IN CALI, COLOMBIA. Am Heart J. 1963 Nov;66:584–596. doi: 10.1016/0002-8703(63)90313-2. [DOI] [PubMed] [Google Scholar]
  7. Cardiomyopathies. Bull World Health Organ. 1965;33(2):257–266. [PMC free article] [PubMed] [Google Scholar]
  8. Chew C. Y., Ziady G. M., Raphael M. J., Nellen M., Oakley C. M. Primary restrictive cardiomyopathy. Non-tropical endomyocardial fibrosis and hypereosinophilic heart disease. Br Heart J. 1977 Apr;39(4):399–413. doi: 10.1136/hrt.39.4.399. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Cockshott W. P., Sarić S., Ikeme A. C. Radiological findings in endomyocardial fibrosis. Circulation. 1967 May;35(5):913–922. doi: 10.1161/01.cir.35.5.913. [DOI] [PubMed] [Google Scholar]
  10. Connor D. H., Somers K., Hutt M. S., Manion W. C., D'Arbela P. G. Endomyocardial fibrosis in Uganda (Davies' disease). 1. An epidemiologic, clinical, and pathologic study. Am Heart J. 1967 Nov;74(5):687–709. doi: 10.1016/0002-8703(67)90509-1. [DOI] [PubMed] [Google Scholar]
  11. Connor D. H., Somers K., Hutt M. S., Manion W. C., D'Arbela P. G. Endomyocardial fibrosis in Uganda (Davies' disease). II. An epidemiologic, clinical, and pathologic study. Am Heart J. 1968 Jan;75(1):107–124. doi: 10.1016/0002-8703(68)90122-1. [DOI] [PubMed] [Google Scholar]
  12. Contreras R., Bialostozky D., Medrano G., Fishleder B., Guadalajara J. F. Fibrosis endomiocárdica Africana o tropical. Comunicación del primer caso observado en México. Arch Inst Cardiol Mex. 1971 Jul-Aug;41(4):476–489. [PubMed] [Google Scholar]
  13. Guimarães A. C., Esteves J. P., Filho A. S., Macedo V. Clinical aspects of endomyocardial fibrosis in Bahia, Brazil. Am Heart J. 1971 Jan;81(1):7–19. doi: 10.1016/0002-8703(71)90049-4. [DOI] [PubMed] [Google Scholar]
  14. Guimarães A. C., Santos Filho A., Esteves J. P., Vinhaes L. S., Abreu W. N. Hemodynamics in endomyocardial fibrosis. Am Heart J. 1974 Sep;88(3):294–303. doi: 10.1016/0002-8703(74)90462-1. [DOI] [PubMed] [Google Scholar]
  15. Hall S. W., Jr, Theologides A., From A. H., Gobel F. L., Fortuny I. E., Lawrence C. J., Edwards J. E. Hypereosinophilic syndrome with biventricular involvement. Circulation. 1977 Jan;55(1):217–222. doi: 10.1161/01.cir.55.1.217. [DOI] [PubMed] [Google Scholar]
  16. Lepley D., Jr, Aris A., Korns M. E., Walker J. A., D'Cunha R. M. Endomyocardial fibrosis. A surgical approach. Ann Thorac Surg. 1974 Dec;18(6):626–633. doi: 10.1016/s0003-4975(10)64411-6. [DOI] [PubMed] [Google Scholar]
  17. McKUSICK V. A., COCHRAN T. H. Constrictive endocarditis; report of a case. Bull Johns Hopkins Hosp. 1952 Jan;90(1):90–97. [PubMed] [Google Scholar]
  18. Moraes C. R., Buffolo E., Victor E., Saraiva L., Gomes J. M., Lira V., Lima R., Escobar M., Andrade J. C. Endomyocardial fibrosis: report of 6 patients and review of the surgical literature. Ann Thorac Surg. 1980 Mar;29(3):243–248. doi: 10.1016/s0003-4975(10)61875-9. [DOI] [PubMed] [Google Scholar]
  19. NAKAJIMA K., OKADA R., UEDA H. A case report of endomyocardial fibrosis. Jpn Heart J. 1961 Apr;2:265–275. doi: 10.1536/ihj.2.265. [DOI] [PubMed] [Google Scholar]
  20. Oakley C. M., Olsen G. J. Eosinophilia and heart disease. Br Heart J. 1977 Mar;39(3):233–237. doi: 10.1136/hrt.39.3.233. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Roberts W. C., Buja L. M., Ferrans V. J. Löffler's fibroplastic parietal endocarditis, eosinophilic leukemia, and Davies' endomyocardial fibrosis: the same disease at different stages? Pathol Microbiol (Basel) 1970;35(1):90–95. doi: 10.1159/000162205. [DOI] [PubMed] [Google Scholar]
  22. Ruggiero H. A., Vales O., Trigo E., Shinji K. Fibrosis endomiocárdica. Prensa Med Argent. 1969 Sep 5;56(27):1339–1343. [PubMed] [Google Scholar]
  23. STUART K. L., HAYES J. A. A cardiac disorder of unknown aetiology in Jamaica. Q J Med. 1963 Apr;32:99–114. [PubMed] [Google Scholar]
  24. Shaper A. G., Hutt M. S., Coles R. M. Necropsy study of endomyocardial fibrosis and rheumatic heart disease in Uganda 1950-1965. Br Heart J. 1968 May;30(3):391–401. doi: 10.1136/hrt.30.3.391. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Spry C. J., Tai P. C. Studies on blood eosinophils. II. Patients with Löffler's cardiomyopathy. Clin Exp Immunol. 1976 Jun;24(3):423–434. [PMC free article] [PubMed] [Google Scholar]
  26. Suárez J. A., De Suárez C. Fibrosis endomiocárdica del ventrículo derecho: estudio anatomopatológico del primer caso venezolano. Acta Cient Venez. 1967;18(4):98–105. [PubMed] [Google Scholar]
  27. Tortoledo R., Dominguez I. Presentación de un case de fibrosis endomiocárdica detectado en la maternidad "Concepción Palacios". Rev Obstet Ginecol Venez. 1969;29(4):529–543. [PubMed] [Google Scholar]

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