Endomyocardial Fibrosis Follow-up

  • Author: Ali A Sovari, MD, FACP; Chief Editor: Henry H Ooi, MBBCh   more...
 
Updated: Jan 21, 2010
 

Transfer

  • Transfer suitable patients with severe symptoms for consideration of endomyocardial resection. Although the operative mortality rate is high (approximately 20%), prognosis is favorably altered in those that survive the surgery.
  • Consider heart transplant in patients who are classified in function class III or IV.
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Deterrence/Prevention

No specific preventive measures have been proven effective.

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Complications

Common postoperative complications include low cardiac output, heart block, and ventricular arrhythmias.

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Prognosis

  • Prognosis for this condition is poor. Incidence of sudden cardiac death from fatal arrhythmias or from progressive cardiac failure is high.
  • Most patients have extensive disease at the time of presentation; therefore, survival after diagnosis is relatively brief. In one study, 95% of a group of patients had died at 2 years. In a second study, 44% of patients died within 1 year after the onset of symptoms, and another 40% of patients died 1-3 years after onset.
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Patient Education

Inform patients about the poor prognosis and increased likelihood of fatal and nonfatal arrhythmias.

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Contributor Information and Disclosures
Author

Ali A Sovari, MD, FACP  Clinical and Research Fellow in Cardiovascular Medicine, Section of Cardiology, University of Illinois College of Medicine; Staff Physician and Hospitalist, St John Regional Medical Center, Cogent Healthcare, Inc

Ali A Sovari, MD, FACP is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, American Physiological Society, and Heart Rhythm Society

Disclosure: Nothing to disclose.

Coauthor(s)

Abraham G Kocheril, MD, FACC, FACP, FHRS  Professor of Medicine, University of Illinois College of Medicine

Abraham G Kocheril, MD, FACC, FACP, FHRS is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, Cardiac Electrophysiology Society, Central Society for Clinical Research, Heart Failure Society of America, and Illinois State Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Hanumant Deshmukh, MD †  Former Chief of Cardiology, Veterans Affairs Medical Center; Former Associate Professor, Department of Medicine, Rosalind Franklin University of Medicine and Science

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Marschall S Runge, MD, PhD  Charles and Anne Sanders Distinguished Professor of Medicine, Chairman, Department of Medicine, Vice Dean for Clinical Affairs, University of North Carolina at Chapel Hill School of Medicine

Marschall S Runge, MD, PhD is a member of the following medical societies: American Association for the Advancement of Science, American College of Cardiology, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Federation for Medical Research, American Heart Association, American Physiological Society, American Society for Clinical Investigation, American Society for Investigative Pathology, Association of American Physicians, Association of Professors of Cardiology, Association of Professors of Medicine, Southern Society for Clinical Investigation, and Texas Medical Association

Disclosure: Pfizer Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Orthoclinica Diagnostica Consulting fee Consulting

Amer Suleman, MD  Private Practice

Amer Suleman, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Institute of Stress, American Society of Hypertension, Federation of American Societies for Experimental Biology, Royal Society of Medicine, and Society of Cardiac Angiography and Interventions

Disclosure: Nothing to disclose.

Chief Editor

Henry H Ooi, MBBCh  Director, Advanced Heart Failure and Cardiac Transplant Program, Nashville Veterans Affairs Medical Center; Assistant Professor of Medicine, Vanderbilt University School of Medicine

Henry H Ooi, MBBCh is a member of the following medical societies: American College of Cardiology, American Heart Association, Heart Failure Society of America, and International Society for Heart and Lung Transplantation

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author James L Furgerson, MD to the development and writing of this article.

References

  1. Rossi S, Baruffi S, Bertuzzi A, Miragoli M, Corradi D, Maestri R, et al. Ventricular activation is impaired in aged rat hearts. Am J Physiol Heart Circ Physiol. Dec 2008;295(6):H2336-47. [Medline].

  2. Miragoli M, Salvarani N, Rohr S. Myofibroblasts induce ectopic activity in cardiac tissue. Circ Res. Oct 12 2007;101(8):755-8. [Medline].

  3. Gupta PN, Valiathan MS, Balakrishnan KG, et al. Clinical course of endomyocardial fibrosis. Br Heart J. Dec 1989;62(6):450-4. [Medline].

  4. Sovari AA, Morita N, Weiss JN, Karagueuzian HS. Serum transforming growth factor-beta1 as a risk stratifier of sudden cardiac death. Med Hypotheses. Aug 2008;71(2):262-5. [Medline].

  5. Valiathan SM, Kartha CC. Endomyocardial fibrosis--the possible connexion with myocardial levels of magnesium and cerium. Int J Cardiol. Jul 1990;28(1):1-5. [Medline].

  6. Mocumbi AO, Ferreira MB, Sidi D, Yacoub MH. A population study of endomyocardial fibrosis in a rural area of Mozambique. N Engl J Med. Jul 3 2008;359(1):43-9. [Medline].

  7. Hassan WM, Fawzy ME, Al Helaly S, Hegazy H, Malik S. Pitfalls in diagnosis and clinical, echocardiographic, and hemodynamic findings in endomyocardial fibrosis: a 25-year experience. Chest. Dec 2005;128(6):3985-92. [Medline].

  8. Rutakingirwa M, Ziegler JL, Newton R, Freers J. Poverty and eosinophilia are risk factors for endomyocardial fibrosis (EMF) in Uganda. Trop Med Int Health. Mar 1999;4(3):229-35. [Medline].

  9. Barretto AC, Mady C, Oliveira SA, et al. Clinical meaning of ascites in patients with endomyocardial fibrosis. Arq Bras Cardiol. Feb 2002;78(2):196-9. [Medline].

  10. Iles L, Pfluger H, Phrommintikul A, Cherayath J, Aksit P, Gupta SN, et al. Evaluation of diffuse myocardial fibrosis in heart failure with cardiac magnetic resonance contrast-enhanced T1 mapping. J Am Coll Cardiol. Nov 4 2008;52(19):1574-80. [Medline].

  11. Brockington IF, Edington GM. Adult heart disease in western Nigeria: a clinicopathological synopsis. Am Heart J. Jan 1972;83(1):27-40. [Medline].

  12. Chopra P, Narula J, Talwar KK, et al. Histomorphologic characteristics of endomyocardial fibrosis: an endomyocardial biopsy study. Hum Pathol. Jun 1990;21(6):613-6. [Medline].

  13. Eling WM, Jerusalem CR, Heinen-Borries UJ, et al. Is malaria involved in the pathogenesis of tropical endomyocardial fibrosis?. Acta Leiden. 1988;57(1):47-52. [Medline].

  14. Falase AO. Aetiological considerations in Nigeria. In: Valiathan MS, Somers K, Kartha CC, eds. Endomyocardial Fibrosis. Oxford, England:. Oxford Univ Press;1993:88, 94.

  15. Freers J, Mayanja-Kizza H, Rutakingirwa M, Gerwing E. Endomyocardial fibrosis: why is there striking ascites with little or no peripheral oedema?. Lancet. Jan 20 1996;347(8995):197. [Medline].

  16. Freers J, Mayanja-Kizza H, Ziegler JL, Rutakingirwa M. Echocardiographic diagnosis of heart disease in Uganda. Trop Doct. Jul 1996;26(3):125-8. [Medline].

  17. Goo HW, Han NJ, Lim TH. Endomyocardial fibrosis mimicking right ventricular tumor. AJR Am J Roentgenol. Jul 2001;177(1):205-6. [Medline].

  18. Jatene MB, Contreras IS, Lameda LC, et al. Endomyocardial fibrosis in infancy. Arq Bras Cardiol. Apr 2003;80(4):438-45. [Medline].

  19. Lowenthal MN. Endomyocardial fibrosis: familial and other cases from northern Zambia. Med J Zambia. 1978 Feb-Mar;12(1):2-7. 1978;12:2-7.

  20. Metras D. Endomyocardial fibrosis and its surgical treatment: Ivory Coast experience. In: Valiathan MS, Somers K, Kartha CC, eds. Endomyocardial Fibrosis. Oxford, England:. Oxford Univ Press;1993:207-19.

  21. Metras D, Coulibaly AO, Ouattara K. The surgical treatment of endomyocardial fibrosis: results in 55 patients. Circulation. Sep 1985;72(3 Pt 2):II274-9. [Medline].

  22. Moraes CR, Buffolo E, Victor E, et al. Endomyocardial fibrosis: report of 6 patients and review of the surgical literature. Ann Thorac Surg. Mar 1980;29(3):243-8. [Medline].

  23. Mousseaux E, Hernigou A, Azencot M, et al. Endomyocardial fibrosis: electron-beam CT features. Radiology. Mar 1996;198(3):755-60. [Medline].

  24. Nieveen J, Huber J. Familial myocardial fibrosis. Acta Med Scand. Nov 1970;188(5):439-45. [Medline].

  25. Niino T, Shiono M, Yamamoto T, et al. A case of left ventricular endomyocardial fibrosis. Ann Thorac Cardiovasc Surg. Jun 2002;8(3):173-6. [Medline].

  26. Parry EH, Abrahams DG. The natural history of endomyocardial fibrosis. Q J Med. Oct 1965;34(136):383-408. [Medline].

  27. Patel AK, Ziegler JL, D'Arbela PG, Somers K. Familial cases of endomyocardial fibrosis in Uganda. Br Med J. Nov 6 1971;4(783):331-4. [Medline].

  28. Puvaneswary M, Joshua F, Ratnarajah S. Idiopathic hypereosinophilic syndrome: magnetic resonance imaging findings in endomyocardial fibrosis. Australas Radiol. Nov 2001;45(4):524-7. [Medline].

  29. Radhakumary C, Kumari TV, Kartha CC. Endomyocardial fibrosis is associated with selective deposition of type I collagen. Indian Heart J. Jul-Aug 2001;53(4):486-9. [Medline].

  30. Roberts WC, Liegler DG, Carbone PP. Endomyocardial disease and eosinophilia. A clinical and pathologic spectrum. Am J Med. Jan 1969;46(1):28-42. [Medline].

  31. Salemi VM, Picard MH, Mady C. Assessment of diastolic function in endomyocardial fibrosis: value of flow propagation velocity. Artif Organs. Apr 2004;28(4):343-6. [Medline].

  32. Shaper AG. The etiology of endomyocardial fibrosis. In: Valiathan MS, Somers K, Kartha CC, eds. Endomyocardial Fibrosis. Oxford, England: Oxford University Press;1993:113.

  33. Shaper AG, Hutt MS, Coles RM. Necropsy study of endomyocardial fibrosis and rheumatic heart disease in Uganda 1950-1965. Br Heart J. May 1968;30(3):391-401. [Medline].

  34. Smedema JP, Winckels SK, Snoep G, et al. Tropical endomyocardial fibrosis (Davies' disease): case report demonstrating the role of magnetic resonance imaging. Int J Cardiovasc Imaging. Dec 2004;20(6):517-22. [Medline].

  35. Somers K, Hutt MS, Patel AK, D'Arbela PG. Endomyocardial biopsy in diagnosis of cardiomyopathies. Br Heart J. Nov 1971;33(6):822-32. [Medline].

  36. Somsen GA, Duren DR. [Heart failure in a Ghanese woman due to endomyocardial fibrosis]. Ned Tijdschr Geneeskd. Aug 26 1995;139(34):1746-8. [Medline].

  37. Urhoghide GE, Falase AO. Degranulated eosinophils, eosinophil granule basic proteins and humoral factors in Nigerians with endomyocardial fibrosis. Afr J Med Med Sci. Sep 1987;16(3):133-9. [Medline].

  38. Valiathan MS, Balakrishnan KG, Sankarkumar R, Kartha CC. Surgical treatment of endomyocardial fibrosis. Ann Thorac Surg. Jan 1987;43(1):68-73. [Medline].

  39. Valiathan MS, Kartha CC. Geochemical basis of tropical endomyocardial fibrosis. In: Valiathan MS, Somers K, Kartha CC, eds. Endomyocardial Fibrosis. Oxford, England:. Oxford University Press;1993:98.

  40. Valiathan MS, Kartha CC, Panday VK, et al. A geochemical basis for endomyocardial fibrosis. Cardiovasc Res. Sep 1986;20(9):679-82. [Medline].

  41. Wynne J, Braunwald E. The cardiomyopathies and myocarditides. In: Braunwald E, ed. Heart Disease. 5th ed. Philadelphia, Pa:. WB Saunders and Co;1997:1433-4.

  42. Zabsonre P, Renambot J, Adoh-Adoh M, et al. [Conduction disorders in chronic parietal endocarditis or endomyocardial fibrosis.170 cases at the Cardiology Institute of Abidjan.]. Dakar Med. 2000;45(1):15-9. [Medline].

 
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