A Challenging Differential Diagnosis: Distinguishing between Endomyocardial Fibrosis and Apical Hypertrophic Cardiomyopathy

作者：Maia Cintia Prado; Gali Luis Gustavo; Schmidt Andre; de Almeida Filho Oswaldo Cesar; Santos Marcel Koenigkam; Lima Saraiva Luciano Albuquerque; Rodrigues Alfredo Jose; Maciel Benedito Carlos; Dias Romano Minna Moreira

来源：Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques, 2016, 33(7): 1080-1084.

DOI：10.1111/echo.13244

• endomyocardial fibrosis
• restrictive cardiomyopathy
• echocardiography
• cardiac magnetic resonance

Endomyocardial fibrosis, which is a cause of restrictive cardiomyopathy, is characterized by the deposition of fibrous tissue in the apical region of 1 or both ventricles. The condition not only affects the diastolic dynamics of the ventricles, but also the function of the atrioventricular valves. The disease occurs predominantly in tropical regions worldwide and in sub-Saharan Africa. This condition is not well understood, with varied manifestations, from subclinical presentations to chronic and progressive edematous syndromes. Here, we present the challenging case of a patient with an indeterminate echocardiographic image, suggesting apical hypertrophy, plus severe aortic stenosis and fibrosis of the left ventricular outflow tract. An electrocardiogram revealed symmetrical T-wave inversion, which is a characteristic manifestation of apical hypertrophy. The importance of cardiac imaging examinations such as echocardiography and cardiac magnetic resonance for differentiating between endomyocardial fibrosis and apical hypertrophy is highlighted in this patient's case.

• 出版日期2016-7