Background An 11-year-old girl presented to a specialist cardiac facility in Mozambique. She had severe heart failure and massive cardiac enlargement, herniation of the heart into the epigastrium, atrial fibrillation, signs of severe pulmonary hypertension and a low cardiac output.
Investigations Chest radiography, echocardiography, 24 h Holter monitoring, and cardiac catheterization.
Diagnosis Left and right endomyocardial fibrosis in conjunction with an aneurysmal left atrium, severe heart failure, and atrial fibrillation.
Management Left ventricular endocardiectomy with mobilization of the chordae tendineae, mitral valve repair, tricuspid annuloplasty, and left atrial resection.
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We would like to acknowledge the Magdi Yacoub Institute and the Chain of Hope for their sponsorship, and Professor M Beatriz Ferreira for her important role and continuous support in the implementation of this surgical collaborative project between the Institute and the Chain of Hope Charity.
The authors declare no competing financial interests.
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Mocumbi, A., Carrilho, C., Burke, M. et al. Emergency surgical treatment of advanced endomyocardial fibrosis in Mozambique. Nat Rev Cardiol 6, 210–214 (2009). https://doi.org/10.1038/ncpcardio1449