title: Angina-like chest pain and syncope as the clinical presentation of left ventricular endomyocardial fibrosis: a case report.
abstract: A 47-year-old woman complained of angina-like chest pain, near-syncope, and syncopal episodes of 17 years' duration. Physical examination was unremarkable. A 12-lead resting ECG showed symmetrically inverted T waves in the inferior and anterolateral leads. A graded treadmill exercise stress test precipitated angina-like chest pain accompanied by a near-syncopal episode associated with a systemic arterial pressure of 60/40 mm Hg. Echocardiography disclosed left ventricular apical obliteration. Left ventriculogram showed a typical "ace of heart'' shadow as well as filling defects and apical obliteration. Endomyocardial biopsy of the left ventricle diagnosed left ventricular endomyocardial fibrosis. Thus, angina-like chest pain and near-syncopal episodes should be added to the list of clinical manifestations of pure left ventricular endomyocardial fibrosis.
authors.affiliation: Cardiology Division, Faculty of Medicine of São José do Rio Preto, Brazil. rbestetti@netsite.com.br
authors.forename: Reinaldo B
authors.initials: RB
authors.lastname: Bestetti
authors.forename: Helio A R
authors.initials: HA
authors.lastname: Corbucci
authors.forename: Luis D
authors.initials: LD
authors.lastname: Fornitano
authors.forename: Moacyr F
authors.initials: MF
authors.lastname: Godoy
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Cury
authors.forename: Daniel
authors.initials: D
authors.lastname: Villafanha
authors.forename: Domingos A
authors.initials: DA
authors.lastname: Santana
authors.forename: Marcelo J F
authors.initials: MJ
authors.lastname: Soares
authors.forename: Domingo M
authors.initials: DM
authors.lastname: Braile
mesh_terms: D002637:Chest Pain / Q000209:etiology*; D004719:Endomyocardial Fibrosis / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013575:Syncope / Q000209:etiology*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis*