Cardiac Disorders Simulating Endomyocardial Fibrosis.

Abstract

Summary: Four patients, aged between 8 and 11 years, whose cardiac disorders closely mimicked endomyocardial fibrosis (EMF) are reported. They all had heart failure, tricuspid regurgitation and globular hearts with no murmurs. In three of the cases, the lung fields were oligaemic. Angio and echocardiographic studies subsequently revealed that the first patient had congenital pulmonary stenosis while the second had a coarctation syndrome. Gross cardiac dilation complicated these two malformations. In the third and fourth patients, the correct diagnoses, dilated cardiomyopathy and constrictive pericarditis respectively, were ascertained only at necropsy. These two lesions should therefore, be considered in the differential diagnosis of EMF. Furthermore, the four cases illustrate the unreliability of basing the diagnosis of this cardiomyopathy on clinical features alone.