Endomyocardial fibrosis (EMF) is a heart disorder of unknown origin that is seen in tropical regions. EMF causes restrictive cardiomyopathy, which is a type of heart disease that makes the heart thickened and stiff such that it cannot fill properly. This ultimately impairs the heart’s ability to properly deliver blood to the body, leading to heart failure. EMF can also cause irregular heartbeats (arrhythmia) or clotting (thromboembolism).
EMF mostly affects those living in tropical or subtropical regions in Asia, Africa, and Latin America. In these areas, EMF is one of the most common cardiac diseases. EMF affects both genders, and is often seen in children, adolescents, and the elderly. Symptoms are generally not recognized until late in the clinical course when patients present with chest pain due to heart dysfunction. Early symptoms include facial swelling, body itching, clots, and elevated white blood cells (eosinophils) in the bloodstream. EMF is similar to Loeffler’s endocarditis, although in EMF it is less likely to have an increased number of eosinophils present in the blood. The cause of EMF is not yet fully understood. Malnutrition combined with high concentrations of cerium, a rare earth element found in tuberous food, has been shown to produce similar symptoms, indicating a possible dietary cause. The risk of EMF may also be heritable.
Treatment for EMF may include heart medication and surgery. Possible medications include blood thinners, anticoagulants, and blood pressure lowering drugs. Surgery is often reserved for advanced cases of EMF due to the risk of mortality, but surgery has been shown to improve heart function and increase life expectancy. If you have been diagnosed with EMF, talk to your doctor about the most current treatment options. Support groups are also available for more resources and information.