Severe Left Ventricular Endomyocardial Fibrosis Presenting as Biventricular Failure in a Young Adult: A Case Report
Published: November 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/22367.8820
Harpreet Singh Sandhu, Sampathkumar Mahadevappa Mahendrakar, Rajebali Ramzanali Pethani, Azizullah Hafizullah Khan, Yunus Shafi Loya
1. FNB Critcal Care Medicine Trainee, Department of Intensive Care Medicine, Prince Aly Khan Hospital, Nesbit Road, Mazgaon, Mumbai, Maharashtra, India.
2. Intensivist, Department of Intensive Care, Prince Aly Khan Hospital, Nesbit Road, Mazgaon, Mumbai, Maharashtra, India.
3. Consulting Physician, Department of Medicine, Prince Aly Khan Hospital, Nesbit Road, Mazgaon, Mumbai, Maharashtra, India.
4. ICU Director, Department of Intensive Care, Prince Aly Khan Hospital, Nesbit Road, Mazgaon, Mumbai, Maharashtra, India.
5. Consulting Cardiologist, Department of Cardiology, Prince Aly Khan Hospital, Nesbit Road, Mazgaon, Mumbai, Maharashtra, India.
Correspondence
Dr. Harpreet Singh Sandhu,
Anaesthesia and Critical Care, FNB Critical Care Medicine Trainee, Department of Intensive Care,
Prince Aly Khan Hospital, Nesbit Road, Mazgaon, Mumbai-400010, Maharashtra, India.
E-mail: itallionstallion17@gmail.com
Endomyocardial Fibrosis (EMF) is a form of progressive restrictive cardiomyopathy of unclear aetiology prevalent in areas within 150 of equator including coastal areas of Kerala a few decades back. It inflicts young adults and carries a poor prognosis due to limited options for treatment. Fortunately, the incidence of cases is now declining due to improvement in health and hygiene standards. Here, we review the aetiology and pathogenesis of EMF and report a case of a young male from Mumbai (non-endemic area) presenting with progressively worsening breathlessness and signs of heart failure unresponsive to conventional medical treatment. To delineate the extent of the disease transthoracic echocardiography and cardiac Magnetic Resonance Imaging (MRI) was done which revealed infiltrative lesions in left ventricular apex with grade 2/3 mitral regurgitation. Due to progressive and severe nature of the disease the patient was managed conservatively. Through this report we would like to rekindle the interest of reader in a forgotten tropical disease which is considered rare in this geographical area but should not be missed as a cause heart failure considering its significant mortality.
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