Left ventricular endomyocardial fibrosis in India

Abstract

Clinical radiological, electrocardiographic, hemodynamic, and cineangiographic features of left ventricular endomyocardial fibrosis are described in 8 patients seen during the period 1965-1975. Exertional dyspnea was the commonest presenting symptom. Mild to moderate cardiomegaly was often present. The apex beat was never forcible. A loud third heart sound over the apex and an apical early systolic murmur with late systolic decrescendo were characteristic of this disease. Chest x-ray films showed left atrial enlargement and pulmonary venous congestion. A pronounced rise in left ventricular end-diastolic pressure, severe pulmonary hypertension, and low cardiac index were seen in 6. Ventriculography showed an irregular, poorly contracting left ventricle with areas of dyskinesis and large end-systolic volume. Mitral regurgitation, when present, was not severe.