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Endomyocardial fibrosis
Other Resources UpToDate PubMed

Endomyocardial fibrosis

Contributors: Michael W. Winter MD, Ryan Hoefen MD, PhD
Other Resources UpToDate PubMed


Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy characterized by abnormal fibrous endocardial thickening of either or both ventricles. Associated with high mortality. The origin of the disease is unknown, and cases occur almost exclusively in regions within 15 degrees of the Equator. In these regions, EMF is a common cause of heart failure, with most cases occurring in adolescents and young adults. In temperate climates, Loeffler disease (see endocarditis) is a nearly identical presentation. Signs and symptoms of EMF include atrioventricular valve regurgitation, enlarged ventricle(s), dyspnea, facial or limb edema, orthopnea, and fatigue. Comorbidities include ascites, pleural / pericardial effusions, and atrial fibrillation / arrhythmia.


I42.3 – Endomyocardial (eosinophilic) disease

398716006 – Endomyocardial Fibrosis

Differential Diagnosis & Pitfalls

  • Congestive heart failure
  • Endocarditis
  • Mitral regurgitation
  • Tricuspid regurgitation
  • Restrictive cardiomyopathy
  • Constrictive Pericarditis
  • Dilated cardiomyopathy
  • Pulmonary hypertension

Best Tests

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Updated:01/25/2024
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Endomyocardial fibrosis
A medical illustration showing key findings of Endomyocardial fibrosis (Left Ventricular) : Fatigue, Exertional dyspnea, EOS increased, Orthopnea, Paroxysmal nocturnal dyspnea
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