Endomyocardial fibrosis presented by ventricular tachycardia: case report

Abstract

BackgroundEndomyocardial fibrosis (EMF) is a form of restrictive cardiomyopathy that is diagnosed mainly in children and young adults and is geographically found in Africa, Latin America, and Asia. It is a condition with high morbidity and mortality, unknown etiology, and no definitive treatment. Although its main clinical presentation is congestive heart failure with or without related supraventricular arrhythmia like atrial fibrillation, it very rarely presents with ventricular arrhythmias and tachycardias (VA, VT).Case presentationWe report a case of right ventricular (RV) EMF presented with recurrent attacks of hemodynamically unstable VT that required direct current (DC) cardioversion. The diagnosis was suspected by transthoracic echocardiography (TTE) and established by cardiac magnetic resonance (CMR). The patient underwent implantable cardioverter–defibrillator (ICD) implantation for secondary prevention of VT, and he was discharged safely on antiarrhythmic drugs with regular follow-up visits.ConclusionEMF presenting with VT are quite rare and to the best of our knowledge, our case is the fourth case in the literature to report VT as a clinical presentation of EMF.

Prevalence and Impact of Arrhythmia on Outcomes in Restrictive Cardiomyopathy—A Report from the Beijing Municipal Health Commission Information Center (BMHCIC) Database

“…Different from previous studies, which showed that heart failure and supraventricular tachycardia are common and ventricular arrhythmia are rare [30], the present cohort found a prevalence of 10.2% (N = 117) of VT. The mechanism of VT in patients with RCM is still unclear, and may be related to myocardial amyloid deposition [31] or subendocardial infarction and fibrosis [32]. Of note, VT is associated with increased mortality [33][34][35][36] but heart failure induced by VT doubles the patient's risk of death with each NYHA grade increase [16].…”

Endomyocardial fibrosis in a non‐tropical patient who presented with chest pain mimicking ACS and left ventricular thrombus, case report

“…The initial phase of the disease is acute carditis, characterized by febrile illness, and in some cases, it progresses to cardiogenic shock. But the vast majority present during the chronic phase with symptoms of heart failure, arrhythmia, and thromboembolism 1,4 …”

“…But the vast majority present during the chronic phase with symptoms of heart failure, arrhythmia, and thromboembolism. 1,4 Generally, the main pathological event is unknown. However, there are multiple theories about its development, and further studies are needed to unfold its etiologies further and help us understand it better.…”

“…But the vast majority present during the chronic phase with symptoms of heart failure, arrhythmia, and thromboembolism. 1 , 4 …”

Endomyocardial Fibrosis in non-tropical patient with no obvious eosinophilia presented with chest pain mimicking ACS and left ventricular thrombus

“…The initial phase of the disease is acute carditis, characterized by febrile illness and in some cases, it progresses to cardiogenic shock. But the vast majority present during the chronic phase with symptoms of heart failure, arrhythmia and/or thromboembolism (1,4).…”