Value of two-dimensional echocardiography in endomyocardial disease with and without eosinophilia. A clinical and pathologic study.
Ten patients (six women and four men) with endomyocardial disease, four with and six without hypereosinophilia, were studied by two-dimensional echocardiography (2-D echo). Eight had biventricular congestive heart failure and two had atypical chest pain with ischemic electrocardiographic changes. The patients were 15-50 years old (mean 40 years) and duration of illness was 2-9 years (mean 4.4 years). Nine had cardiac catheterization and three pathologic examination. Characteristic 2-D echo findings included apical obliteration of one or both ventricles by echogenic material suggestive of fibrosis or thrombosis; bright, specular echoes at the cavity surface of the apical obliteration suggesting patchy calcification; preserved left apical systolic inward motion, which differed significantly from the dyskinetic motion of thrombotic apical obliteration of ischemic or Chagasic origin (p less than 0.001); involvement of the papillary muscles and posterior atrioventricular valve; preserved ventricular contractile function in most patients; and the combination of normal-to-small ventricles with large atria. None of 14 subjects with secondary hypereosinophilia followed for 15.4 months developed similar 2-D echo findings. We conclude that both forms of endomyocardial disease had a 2-D echo pattern useful for noninvasive recognition and differentiation from patients who have valvular heart disease, constrictive pericarditis and cardiomyopathies of other origins.
D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization; D003937:Diagnosis, Differential; D004452:Echocardiography; D004719:Endomyocardial Fibrosis / Q000150:complications / Q000175:diagnosis*; D004802:Eosinophilia / Q000209:etiology*; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010494:Pericarditis, Constrictive / Q000175:diagnosis; D013997:Time Factors