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“Burnt-Out” endomyocardial fibrosis—An Overview

Case Reports in Clinical Medicine 2016年第11期5卷 437-493页

作者： Ramachandran Muthiah Thoothukudi Medical College Hospital Thoothukudi India

Tropical endomyocardial fibrosis (EMF) is a public health problem affecting the children, young adults and elderly individuals in an epidemic fashion in the coastal districts of south India. Due to lack of resources for research in these endemic areas, its etiology remains elusive and hypotheses ranging from infections and allergic causes to malnutrition and toxins have not been tested rigorously. The disease is characterized by endocardial fibrosis and the right ventricle is the cardiac chamber most frequently affected. Patients may present clinically with heart failure and an associated AV (atrioventricular) valve regurgitation is common. Several features of the advanced disease called as “burnt-out” stage of endomyocardial fibrosis (EMF) are not fully understood. Background of these case studies described the clinical presentation, echocardiographic features and management of this late stage of the disease.

关键词： endomyocardial fibrosis Burnt-Out Stage Pericardial Effusion Endocardial Calcification “Cobra-Head” fibrosis

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Right Ventricular Thrombus and Tricuspid Valve Dysfunction in a Patient with Behçet’s Disease

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Case Reports in Clinical Medicine 2020年第10期9卷 319-328页

作者： Federica Valente Christian Motet Stefan Rusu Frederic Vandergheynst Department of Cardiology Erasme University Hospital Université Libre de Bruxelles Brussels Belgium Department of Internal Medicine CHU Tivoli Université Libre de Bruxelles Brussels Belgium Pathology Department Erasme University Hospital Université Libre de Bruxelles Brussels Belgium Department of Internal Medicine Erasme University Hospital Université Libre de Bruxelles Brussels Belgium

Background: Behçet’s disease (BD) is a multisystemic, chronic inflammatory disorder with a broad range of manifestations including within the cardiovascular system. Cardiac involvement like intracardiac thrombus (ICT) and valvular involvement in BD are rarely seen entities and often associated with poor prognosis. Case Presentation: We present the case of a young patient with vascular-Behçet diagnosed by the presence of intracardiac thrombus in the right ventricle, unresponsive to medical treatment. Even though the intracardiac lesion was successfully treated by surgical excision, he presented a severe tricuspid dysfunction some years later due to the extension of fibrosis with no surgical therapeutic option. Conclusion: Intracardiac thrombosis is a rare but early manifestation of Behçet’s disease, which is difficult to diagnose and has a poor prognosis.

关键词： Behçet’s Disease Cardiac Involvement Intracardiac Thrombosis Tricuspid Valve Regurgitation endomyocardial fibrosis

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Cardiomyopathies in Tropical Countries:Causes and Nosological Perspective

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World Journal of Cardiovascular Surgery 2013年第7期3卷 201-208页

作者： Jean-Etienne Touze Laurent Fourcade Centre Cardiovasculaire Valmante ORPEA-Clinea GroupMarseillesFrance Service de cardiologie Hopital d’Instruction des Armees LaveranMarseilleFrance

Background: Cardiomyopathy is the main cause of heart failure in developing countries, mainly in Africa. In those areas the concept of “tropical cardiomyopathy” is still used to design all unexplained cardiomyopathy. The primary aim of this review is first to review the main etiologies of cardiomyopathies observed in tropical countries and second to gain a better understanding of the nosological place of the so-called “tropical cardiomyopathies” in the current framework of cardiomyopathies. Methods and Results: We reviewed relevant references over the last forty years (June, 1976 to May 2012). Given literature data, endomyocardial fibrosis (EMF) is mainly diagnosed in sub-Saharan countries, as well as Brazil and India. Peripartum cardiomyopathy (PPCM) is observed with a higher prevalence than in temperate countries. Sickle cell anemia does not induce specific cardiomyopathy in all echocardiographic studies. Malnutrition and chronic anemia can induce reversible cardiac dysfunction. Myocardial involvement in parasitic infections is restricted to Chagas disease and probably to human African trypanosomiasis. Helminthiasis is not involved in the pathogenesis of cardiomyopathy except for the deleterious effect of high eosinophilia induced by some endemic diseases (filariasis, schistosomiasis). Primary cardiomyopathies (dilated, hypertrophic, and restrictive cardiomyopathy) have no specificity. Arrhythmogenic right ventricular dysplasia and left ventricular noncompaction are also reported and do not differ from elsewhere. Conclusions: The concept of tropical cardiomyopathy is no longer relevant as most of the cardiomyopathies observed in tropical countries have no specificity, with few exceptions (PPCM, EMF, Chagas disease). In this context, the European Society of Cardiology classification offers a simpler clinical approach and allows the inclusion of the rare tropical specificities.

关键词： Tropical Countries Cardiomyopathy endomyocardial fibrosis Peripartum Cardiomyopathy Chagas Disease

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