Black Esophagus in Critical Patient

Background: Endomyocardial fibrosis (EMF) is a grim disease. It is the most common restrictive cardiomyopathy worldwide,1 but its exact etiology and pathogenesis remain unknown. It seems likely that dietary, environmental, and infectious factors may combine in a susceptible individual to give rise to an inflammatory process leading to endomyocardial damage and scar formation. 2 An extensive ventricular endocardium fibrosis distorts ventricular architecture and leads to a restrictive physiology. Impaired filling and valvular insufficiency define the disease. Many times it is associated to hypereosinophilic endocarditis. This tropical cardiomyopathy presents most cases in Africa, Asia, and South America. Case presentation: We present a 67-year-old male patient with restrictive cardiomyopathy and mitral valve insufficiency due to EMF. The patient was referred a history of schistosome infection in the childhood. He has presented no other risk factors described in the literature. After treatment with diuretics and vasodilators, he underwent a successful surgical resection of endocardial ventricular fibrosis, mitral valve replacement and two saphenous bypasses. Conclusions: The aim of this case report is to highlight the disease and to show how challenging is the endomyocardium fibrosis’s treatment and the importance of an earlier diagnosis as well as more researches on this topic.