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Mocumbi was the lead investigator assessed a random sample of 1,063 individuals of all ages selected by clustering in a rural area of Mozambique with about 76,000 inhabitants, and found an endomyocardial fibrosis prevalence of 20%.
43) Such conditions include sarcoidosis, hypertrophic cardiomyopathy, connective tissue diseases, endomyocardial fibrosis and amyloid infiltration (Figure 7).
Cardiac magnetic resonance imaging (MRI) showed biventricular systolic dysfunction; late gadolinium imaging revealed the presence of left ventricular thrombus and a non-ischaemic subendocardial enhancement with a classical 'zebra sign', compatible with a diagnosis of endomyocardial fibrosis.
Transesophageal and transthoracic echocardiography imaging might suggest a differential diagnosis a large vegetation, an intracardiac tumor such as a myxoma, or endomyocardial fibrosis but the clinical context helps to clarify the diagnosis (7).
Endomyocardial fibrosis along with the root wilt disease of coconut is endemic to Kerala with its radioactive actinide beach sands.