Endocardial Fibroelastosis

Abstract

A clinical and pathologic study of 47 cases with endocardial fibroelastosis is presented. These cases have been classified according to the associated cardiac anomaly and the anatomic condition of the left ventricle. In so doing, a better understanding is had of the role the cardiac anomaly associated with endocardial fibroelastosis plays in the production of cardiac signs and symptoms.In each of the specimens available for review, a change of the mitral valve was present that rendered it insufficient. Those cases grouped as primary endocardial fibro-elastosis had this as the only abnormality present, other than the endocardial fibroelastosis. Many of the clinical and laboratory findings in this group could be explained on the basis of mitral insufficiency, and one cannot necessarily assign the cardiac signs and symptoms to the endocardial process itself. In those cases with associated cardiac anomalies the hemodynamic consequences appear to be a summation of the combined effects of the mitral insufficiency, endocardial fibroelastosis, and the associated cardiac anomaly.In this review, we were unable to distinguish, by either gross or microscopic methods, between primary and secondary endocardial fibroelastosis. Since use of these terms suggests etiologic relations, it is preferable to classify cases of endocardial fibroelastosis on the basis of the structural abnormalities present.