A Challenging Differential Diagnosis: Distinguishing between Endomyocardial Fibrosis and Apical Hypertrophic Cardiomyopathy

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• 作者：Cintia Prado Maia ; Luí ; s Gustavo Gali ; André ; Schmidt ; Oswaldo Cé ; sar de Almeida Filho ; Marcel Koenigkam Santos ; Luciano Albuquerque Lima Saraiva ; Alfredo José ; Rodrigues ; Benedito Carlos Maciel and Minna Moreira Dias Romano
• 刊名：Echocardiography
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：33
• 期：7
• 页码：1080-1084
• 全文大小：674K
• ISSN：1540-8175

文摘

Endomyocardial fibrosis, which is a cause of restrictive cardiomyopathy, is characterized by the deposition of fibrous tissue in the apical region of 1 or both ventricles. The condition not only affects the diastolic dynamics of the ventricles, but also the function of the atrioventricular valves. The disease occurs predominantly in tropical regions worldwide and in sub-Saharan Africa. This condition is not well understood, with varied manifestations, from subclinical presentations to chronic and progressive edematous syndromes. Here, we present the challenging case of a patient with an indeterminate echocardiographic image, suggesting apical hypertrophy, plus severe aortic stenosis and fibrosis of the left ventricular outflow tract. An electrocardiogram revealed symmetrical T-wave inversion, which is a characteristic manifestation of apical hypertrophy. The importance of cardiac imaging examinations such as echocardiography and cardiac magnetic resonance for differentiating between endomyocardial fibrosis and apical hypertrophy is highlighted in this patient's case.