Haemodynamic features of severe endomyocardial fibrosis of right ventricle, including comparison with constrictive pericarditis.

Endomyocardial fibrosis, first described from Uganda by Davies (1948), is a disease of the heart characterized by a fibrosis of the endocardium and subendocardial layers of either the left or right ventricle or both. The fibrosis affects mostly the inflow tracts and the apices of the ventricles, and involvement of the papillary muscles may lead to mitral or tricuspid incompetence. The ventricular outflow tracts are unaffected and the aortic and pulmonary valves are normal. Van der Geld et al. (1966) have demonstrated a predisposition to autoimmune reactivity to the heart in endomyocardial fibrosis. Connor et al. (1967, 1968) have recently published a detailed account of the histopathology of endomyocardial fibrosis in Uganda. From a clinical survey of all cardiac diseases, excluding hypertensive heart disease, at Mulago Hospital, Somers and D'Arbela (1964) found the incidence of endomyocardial fibrosis to be approximately 12 per cent. Over the past three years 28 patients with severe endomyocardial fibrosis of the right ventricle have been investigated here by right heart catheterization. Their clinical features are' described elsewhere (Somers, Brenton, and Sood, 1968). This present paper records the observations made during catheterization of these patients, and compares the data with those obtained in 11 patients with constrictive pericarditis. The effect of an intravenous administration of a digitalis preparation in 11 patients with right ventricular endomyocardial fibrosis is reported. The results of a similar study have been published by Parry and Abrahams (1963). Many of their