The Pathology of Endomyocardial Fibrosis

pp 419-426

Abstract

Endomyocardial fibrosis was described for first time by Davies in Uganda. It was considered as an exotic cardiomyopathy in Argentine. The surgical pathology (n = 3), endomyocardial biopsy (n = 1) and autopsy (n = 1) findings are herein reported. The age was 40.8 average (range 28-64). Endomyocardial fibrosis was not suspected clinically in any case. The suggested diagnosis were dilated cardiomyopathy (n = 1) severe mitral insufficiency (n = 2) and restrictive cardiomyopathy (n = 2). All patients presented with refractory cardiac failure. Two patients suffering from associated severe mitral insufficiency died during surgery. In two patients with restrictive cardiomyopathy, the diagnosis of endomyocardial fibrosis was obtained during the surgical intervention and in the other by endomyocardial biopsy. The remaining patient died because of a dilated cardiomyopathy, and the diagnosis was potmortem. Biventricular compromise and right ventricular cavity obliteration because of the growth of dense connective tissue and apical thrombi was observed in all cases. The classical microscopic pattern consisting of dense collagen tissue, with scarce elastic component, invading the close subendocardial areas and causing myocyte atrophia- necrosis was the rule. Endomyocardial biopsy is obligatory for the diagnosis of the disease