Endocardial Fibroelastosis Treatment & Management

Updated: Feb 21, 2014
  • Author: Poothirikovil Venugopalan, MBBS, MD, FRCPCH; Chief Editor: Stuart Berger, MD  more...
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Treatment

Medical Care

The treatment of endocardial fibroelastosis (EFE) is essentially the same as that of chronic cardiac failure; its acute exacerbations are often precipitated by respiratory infections.

Early and prolonged treatment with digoxin is suggested. Continue therapy for several years after the symptoms disappear; cessation of drug administration may result in acute cardiac failure, even when heart size has returned to normal.

Other measures for acute failure and exacerbations of failure may be required, and precipitating factors, such as infection and anemia, require attention.

Anticoagulation may be required in the presence of thromboembolic complications.

Case reports in the literature cite resolution of antenatally diagnosed endocardial fibroelastosis associated with positive anti-Ro and anti-La antibodies with corticosteroid therapy.

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Surgical Care

Both pericardial poudrage and mitral valve (MV) replacement have had disappointing results.

Cardiac transplantation may be recommended for patients with end-stage disease.

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Consultations

Consider consultations with the following specialists:

  • Pediatric cardiologist

  • Radiologist

  • Nuclear medicine specialist

  • Family physician

  • Occupational therapist

  • Physiotherapist

  • Psychologist

  • School teacher

  • Specialist nurse

  • Pharmacist

  • Dietitian

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Diet

Diet is dictated by the underlying heart disease and degree of malnutrition.

The Academy of Nutrition and Dietetics provides recommendations regarding heart failure and evidence-based nutrition.

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Activity

Limitations to activity are dictated by the symptomatology.

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