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

This report aims to increase the attention and awareness of this disease. We present a case of a 53-year-old man referred to the emergency department for sudden chest pain, left-sided and non-radiating lasted for several minutes, awoke him from sleep with no associated symptoms. He is known to have Diabetes type-2 and hypertension on oral therapy. Cardiac markers were within the normal limit. The patient was discharged home with an appointment at the cardiology outpatient clinic. Echocardiography was done and revealed mildly reduced left ventricular (LV) systolic function, Ejection Fraction of 46%, asymmetric LV hypertrophy affecting the apical segments with aneurysm, and calcified apical thrombus. CT coronary angiography was done with non-significant Left Anterior Descending artery lesions and left ventricular hypertrophy affecting the apex with calcified apical thrombus. Further investigation by cardiac MRI revealed apical thrombus and late apical uptake suggesting Endomyocardial Fibrosis of possible eosinophilic etiology. The patient continued to have attacks of similar chest pain, for which stress cardiac MRI was done and was negative for ischemia. Another diagnostic workup was done, including hematological and serological tests such as Antinuclear Antibodies and Schistosoma Antibodies. The patient was kept on valsartan and Bisoprolol with oral anticoagulant (vitamin K antagonist) and Rosuvastatin. EMF may have a heterogeneous presentation and should be considered in a pa...
Source: Clinical Case Reports - Category: General Medicine Authors: Tags: CASE REPORT Source Type: research