Radiological findings in endomyocardial fibrosis

• Published in: Circulation (New York, N.Y.) Vol. 35; no. 5; pp. 913 - 922
• Main Authors: Cockshott, W P, Sarić, S, Ikeme, A C
• Format: Journal Article
• Language: English
• Published: United States 01-05-1967
• Subjects: Adolescent; Adult; Angiocardiography; Calcinosis - diagnostic imaging; Child; Diagnosis, Differential; Endomyocardial Fibrosis - diagnostic imaging; Female; Heart Atria - diagnostic imaging; Heart Diseases - diagnostic imaging; Heart Ventricles - diagnostic imaging; Humans; Male; Middle Aged; Mitral Valve Insufficiency - diagnostic imaging; Pericardial Effusion - diagnostic imaging; Rheumatic Heart Disease - diagnostic imaging; Tricuspid Valve Insufficiency - diagnostic imaging
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.35.5.913

The radiological findings in 102 cases of endomyocardial fibrosis occurring in Equatorial Africa are presented. Postmortem studies confirmed the diagnosis in 39 cases. Angiocardiography was done in 78. The right side of the heart was primarily involved in 48 patients and the cardiac silhouette was characteristically globular suggesting a pericardial effusion, the large heart having a conspicuous background of oligemic pulmonary fields. Angiocardiography usually revealed a dilated right atrium and ventricle, extremely slow transit of the contrast material, and tricuspid incompetence. Occasionally, a filling defect in the right atrium, interpreted as thrombus, was seen.
The left side of the heart was established as being primarily involved in 13 cases and the picture of rheumatic mitral disease was simulated. Angiocardiography revealed a rather small left ventricle and mitral regurgitation. Biventricular disease was present in 42 patients, the main differentiating point in routine films from right endomyocardial fibrosis being the size of the superior pulmonary veins. The complete diagnosis is difficult to detect without angiographic studies.