title: Severe Left Ventricular Endomyocardial Fibrosis Presenting as Biventricular Failure in a Young Adult: A Case Report.
abstract: Endomyocardial Fibrosis (EMF) is a form of progressive restrictive cardiomyopathy of unclear aetiology prevalent in areas within 150of equator including coastal areas of Kerala a few decades back. It inflicts young adults and carries a poor prognosis due to limited options for treatment. Fortunately, the incidence of cases is now declining due to improvement in health and hygiene standards. Here, we review the aetiology and pathogenesis of EMF and report a case of a young male from Mumbai (non-endemic area) presenting with progressively worsening breathlessness and signs of heart failure unresponsive to conventional medical treatment. To delineate the extent of the disease transthoracic echocardiography and cardiac Magnetic Resonance Imaging (MRI) was done which revealed infiltrative lesions in left ventricular apex with grade 2/3 mitral regurgitation. Due to progressive and severe nature of the disease the patient was managed conservatively. Through this report we would like to rekindle the interest of reader in a forgotten tropical disease which is considered rare in this geographical area but should not be missed as a cause heart failure considering its significant mortality.
authors.affiliation: FNB Critcal Care Medicine Trainee, Department of Intensive Care Medicine, Prince Aly Khan Hospital , Nesbit Road, Mazgaon, Mumbai, Maharashtra, India .
authors.forename: Harpreet Singh
authors.initials: HS
authors.lastname: Sandhu
authors.affiliation: Intensivist, Department of Intensive Care, Prince Aly Khan Hospital , Nesbit Road, Mazgaon, Mumbai, Maharashtra, India .
authors.forename: Sampathkumar Mahadevappa
authors.initials: SM
authors.lastname: Mahendrakar
authors.affiliation: Consulting Physician, Department of Medicine, Prince Aly Khan Hospital , Nesbit Road, Mazgaon, Mumbai, Maharashtra, India .
authors.forename: Rajebali Ramzanali
authors.initials: RR
authors.lastname: Pethani
authors.affiliation: ICU Director, Department of Intensive Care, Prince Aly Khan Hospital , Nesbit Road, Mazgaon, Mumbai, Maharashtra, India .
authors.forename: Azizullah Hafizullah
authors.initials: AH
authors.lastname: Khan
authors.affiliation: Consulting Cardiologist, Department of Cardiology, Prince Aly Khan Hospital , Nesbit Road, Mazgaon, Mumbai, Maharashtra, India .
authors.forename: Yunus Shafi
authors.initials: YS
authors.lastname: Loya
keywords: Eosinophilia; Heart failure; Tropical disease