“…4) But there seems little reason to doubt that this patient had endomyocardial fibrosis. The diseases with which it could be confused are endocarditis parietalis fibroplastica (Loffler)27) and cardiovascular collagenosis with mural thrombus (Becker).28) These are, however, easily ruled out by the history, clinical and laboratory findings, and pathological examination.…”
Section: Discussionmentioning
confidence: 99%
“…The protein content of the pericardial fluid was high, always over 3.0Gm%. At last, the pericardiectomy was performed on Feb. 4,1975. However, the patient died after the operation.…”
“…4) But there seems little reason to doubt that this patient had endomyocardial fibrosis. The diseases with which it could be confused are endocarditis parietalis fibroplastica (Loffler)27) and cardiovascular collagenosis with mural thrombus (Becker).28) These are, however, easily ruled out by the history, clinical and laboratory findings, and pathological examination.…”
Section: Discussionmentioning
confidence: 99%
“…The protein content of the pericardial fluid was high, always over 3.0Gm%. At last, the pericardiectomy was performed on Feb. 4,1975. However, the patient died after the operation.…”
“…An association with eosinophils in the pathogenesis of endomyocardial fibrosis was already suggested by Davies and Ball (1955). Subsequently, Parry and Abrahams (1965) noted patients in Nigeria, either diagnosed as Loffler's disease or heart muscle disease due to filariasis.…”
Summary
The studies leading up to the unitarian concept suggesting that endomyocardial fibrosis, described in the tropics, and Löffler’s endocarditis parietalis fibroplastica (Löffler’s endomyocardial disease), described in the temperate zone, belong to the same disease spectrum are detailed. Evidence that the eosinophil is involved in the pathogenesis of endomyocardial diseases, irrespective of the geographical origin, is presented. The findings of a similar abnormality in these cells obtained from patients in the tropical and temperate zones are briefly mentioned. In view of the evidence it is proposed that endomyocardial disease, associated with abnormal eosinophils, hitherto classified under the restrictive type of cardiomyopathy, be removed from this classification and reclassified under ‘specific heart muscle disease’.
“…[1,2] Although first described in Uganda, [3] this condition has been documented throughout the world, particularly in tropical and subtropical zones in Africa, Asia and South America. [1,2] Its aetiology remains elusive.…”
Endomyocardial fibrosis remains a major public health problem worldwide. It is a restrictive cardiomyopathy, of uncertain aetiology, which may lead to right, left or biventricular heart failure. Progress continues to be made in understanding the prevalence and natural history of this disease. Specific treatment, apart from surgery, remains suboptimal. We report a case of advanced, biventricular EMF complicated by right ventricular outflow tract aneurysms.
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