Tropical Endomyocardial Fibrosis (EMF) snrunken ventnoes Hallmark chronic EMF features include: • Apical obliteration of the left and/or right ventricles with fibrous tissue deposition, seen as a 3-layered delayed enhancement pattern of normal myocardium, thickened enhanced endomyocardium with overlying thrombus in cardiac MR (double V sign). • Restrictive physiology with shrunken ventricles and marked atria enlargement secondary to fibrosis of the chordae tendineae and papillary muscles leading to mitral and/ Pathogenesis Theories • No clear consensus • Eosinophilia may play a role • Parasitic disease may act as trigger of autoimmunity • Linked to malnutrition and environmental factors • Genetic susceptibility Acute Phase • Acute febrile illness with nonspecific symptoms • Signs of pancarditis with myocardial edema • Thromboembolic events may occur • Subset evolves into chronic phase Chronic Phase • Restrictive heart failure symptoms • Hallmark features seen on cardiac MR • Hepatosplenomegaly and disproportional ascites • Poor prognosis #Tropical #Endomyocardial #Fibrosis #EMF #cardiology #diagnosis
