Endomyocardial fibrosis: Report on the hemodynamic data in 29 patients and review of the results of surgery

Endomyocardial Fibrosis: Clinical, Echocardiographic and Hemodynamic Findings

“…It has been recognized in other areas [7][8][9][10][11][12]. We recognized this disease in the Middle East for the first time in 1980 [4,5].…”

“…There was reversed diastolic pressure gradient across the pulmonary valve, as reported by others [11,21,23]. It has been suggested that the reversed diastolic gradient across the pulmonary valve allows diastolic flow from the right ventricle to the pulmonary artery, but it is not certain whether this contributes significantly to cardiac output.…”

“…Left ventricular involvement was characterized by obliteration of the apex in all patients with biventricular or left ventricle EMF (Figure 3). Mitral regurgitation was severe in six patients (Cases 7,8,11,(15)(16)(17), mild in four (Cases 9,12,13,18), or absent in two (Cases 10 and 14). Obliteration of both ventricular apices was observed in biventricular EMF.…”

“…The initial diagnosis was constrictive pericarditis in five patients (Cases 1,2,6,13,14), rheumatic mitral or tricuspid regurgitation in six patients (Cases 7,8,(15)(16)(17)(18), dilated cardiomyopathy in three ( Cases 9,11,12), and Ebstein's malformation of the tricuspid valve in one patient (Case 3) (Table 1).…”

“…The left ventricular end-diastolic volume is characteristically normal, even in patients with severe mitral regurgitation, and the end-diastolic pressure is very high in patients with left-sided EMF [4,11]. The ventricular end-diastolic volume increases in patients with poor ventricle and severe hypokinesia of the remaining ventricle, representing a very late stage of the disease.…”