Endomyocardial Fibrosis in Two Brothers.

Endomyocardial fibrosis is a very rare form of heart disease in temperate climates but is fairly common in tropical and sub-tropical parts of Africa. Since Bedford and Konstam (1946) first described the disease in West African soldiers, many reports have appeared from various parts of Africa: from Uganda (Davies, 1948), the Sudan (O'Brien, 1954), Nigeria (Nwokolo, 1955; Abrahams, 1959, 1962), and from Kenya and Tanganyika (Turner and Manson-Bahr, 1960). In these areas, the disease afflicts the indigenous African populations almost exclusively, cases among the expatriate residents being very rare, although they have been described (Gray, 1951). Cases have also been reported from outside Africa, notably from America (Clark, Valentine, and Blount, 1956), Great Britain (Evans, 1957), and Holland (Van Buchem, Arends, and Schroder, 1959). The etiology of the disease is unknown. Malnutrition, infection, parasitic infestation, allergy, and lately rheumatic fever (Abrahams and Brigden, 1961) have been mentioned as being sometimes coexistent and therefore possible etiological agents. However, as yet there have been no reports of cases occurring in sibs, and for this reason, two brothers are reported in whom endomyocardial fibrosis was diagnosed clinically.