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Title: Current perspective on endomyocardial fibrosis
Authors: Tharakan, J
Bohora, S
Keywords: Science & Technology - Other Topics
Issue Date: 2009
Citation: 97 ,3;405-410
Abstract: Endomyocardial fibrosis (EMF) is an obliterative cardiomyopathy of uncertain etiology, with fibrotic deposits on the endocardial surface of the apices and inflow of either or both ventricles. The clinical presentation depends largely on the extent of diastolic ventricular filling abnormality and atrio-ventricular valve incompetence, subsequent to involvement of chordo-papillary mechanism by the fibrotic process. Its prevalence is typically seen in the tropical regions and clinical diagnosis is facilitated by the availability of 2D echo Doppler evaluation. Over the past three decades, there has been a significant down trend in both the prevalence and severity in the presentation of EMF. It is postulated that the less severely involved cases are presenting later in the course of natural history of the disease, as evidenced by the higher age group and the less severe clinical symptomatology of patients. Surgical intervention is limited to severely symptomatic patients, as the fibrotic process rarely progresses over time, though the resultant hemodynamic alteration can progress over time, resulting in clinical deterioration.
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