Haemodynamic features of severe endomyocardial fibrosis of right ventricle, including comparison with constrictive pericarditis.

Abstract

The results of cardiac catheterization in 28 patients with severe endomyocardial fibrosis of the right ventricle are described. The reduced compliance of the right ventricle results in a high end-diastolic pressure in this chamber and an increase in the right atrial pressure. The a and v waves of the right atrial trace are approximately equal in size in most patients, but either the a or the v wave may be the larger of the 2. The y descent is always steep. In the absence of left ventricular endomyocardial fibrosis the pulmonary pressures are normal. Cardiac output and stroke volume are usually low in these patients. Patients with constrictive pericarditis have very similar right atrial pressure curves, but there is usually a greater rise of pressure during right ventricular systole and mild to moderate pulmonary hypertension, Digitalis preparations caused slowing of the heart rate in patients with endomyocardial fibrosis and atrial fibrillation, but this was not accompanied by any significant fall of right atrial pressure.