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Echocardiographic profile of endomyocardial fibrosis in Tanzania, East Africa.

OBJECTIVES
To demonstrate and evaluate the usefulness of two dimensional and Doppler echocardiography in the diagnosis of endomyocardial fibrosis (EMF) in countries with poor resources. Also to evaluate the clinical assessment as a predictor of echocardiographically proven EMF.


DESIGN
Descriptive hospital based study.


SETTING
Muhimbili National Hospital, Dar es Salaam, Tanzania.


SUBJECTS
39 patients (27 male and 12 female, mean age 13.5 years) attending our Cardiac Clinic were investigated to determine the extent to which specific features could be diagnosed by transthoracic echocardiography.


MAIN OUTCOME MEASURES
Identifying and characterizing echocardiographic features specific for diagnosing EMF non-invasively.


RESULTS
Only eight (21%) patients had a correct clinical diagnosis, leaving 79% of the patients at risk of being misdiagnosed and hence wrongly receiving expensive treatment. The majority of the patients (69.2%) presented with signs of elevated systemic venous pressure due to right ventricular EMF.


CONCLUSION
We have demonstrated that echocardiography remains a fundamental investigation in the least developed countries in achieving the correct diagnosis.