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Angina-Like Chest Pain and Syncope as the Clinical Presentation of Left Ventricular Endomyocardial Fibrosis

A Case Report

Cardiology Division, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto city, Brazil, rbestetti{at}netsite.com.br

Helio A.R. Corbucci, MD

Cardiology Division, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto city, Brazil

Luis D. Fornitano, MD

Cardiology Division, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto city, Brazil

Moacyr F. Godoy, MD, PhD

Cardiology Division, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto city, Brazil

Patricia M. Cury, MD, PhD

Cardiology Division, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto city, Brazil

Daniel Villafanha, MD

Cardiology Division, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto city, Brazil

Domingos A. Santana, MD

Cardiology Division, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto city, Brazil

Marcelo J.F. Soares, MD

Cardiology Division, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto city, Brazil

Domingo M. Braile, MD, PhD

Cardiology Division, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto city, Brazil

A 47-year-old woman complained of angina-like chest pain, near-syncope, and syncopal episodes of 17 years’ duration. Physical examination was unremarkable. A 12-lead resting ECG showed symmetrically inverted T waves in the inferior and anterolateral leads. A graded treadmill exercise stress test precipitated angina-like chest pain accompanied by a near-syncopal episode associated with a systemic arterial pressure of 60/40 mm Hg. Echocardiography disclosed left ventricular apical obliteration. Left ventriculogram showed a typical "ace of heart" shadow as well as filling defects and apical obliteration. Endomyocardial biopsy of the left ventricle diagnosed left ventricular endomyocardial fibrosis. Thus, angina-like chest pain and near-syncopal episodes should be added to the list of clinical manifestations of pure left ventricular endomyocardial fibrosis.

Angiology, Vol. 56, No. 3, 339-342 (2005)
DOI: 10.1177/000331970505600316


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