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Angiographic features of endomyocardial fibrosis

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A 32 year old woman had restrictive cardiomyopathy caused by endomyocardial fibrosis proven at biopsy. Left ventricular injection showed grade III obliteration of the cavity (obliteration of half or more of cavity). Apical obliteration was lobulated. Obliteration of the apex resulted in a short axis dimension that was longer than the long axis dimension. There was no mitral regurgitation. The mitral valve crescent was indistinct because of fibrosis of the posterior cusp. There was myocardial calcification in the inferior wall (arrowhead bottom right).