{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T04:26:12Z","timestamp":1764476772449,"version":"3.46.0"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T00:00:00Z","timestamp":1653264000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Endomyocardial fibrosis (EMF) is a disease known to cause restrictive cardiomyopathy. It shows a high prevalence in tropical countries. Several triggering factors have been proposed. However, the pathogenesis is still a mystery. The disease is progressive, and the outcome is generally unfavorable. The most common symptom is heart failure. However, an atypical presentation may be expected. Our case presented with symptoms suggestive of ischemia and missed diagnosis initially as ischemic cardiomyopathy. This report aims to increase the attention and awareness of this disease. We present a case of a 53\u2010year\u2010old man referred to the emergency department for sudden chest pain, left\u2010sided and non\u2010radiating lasted for several minutes, awoke him from sleep with no associated symptoms. He is known to have Diabetes type\u20102 and hypertension on oral therapy. Cardiac markers were within the normal limit. The patient was discharged home with an appointment at the cardiology outpatient clinic. Echocardiography was done and revealed mildly reduced left ventricular (LV) systolic function, Ejection Fraction of 46%, asymmetric LV hypertrophy affecting the apical segments with aneurysm, and calcified apical thrombus. CT coronary angiography was done with non\u2010significant Left Anterior Descending artery lesions and left ventricular hypertrophy affecting the apex with calcified apical thrombus. Further investigation by cardiac MRI revealed apical thrombus and late apical uptake suggesting Endomyocardial Fibrosis of possible eosinophilic etiology. The patient continued to have attacks of similar chest pain, for which stress cardiac MRI was done and was negative for ischemia. Another diagnostic workup was done, including hematological and serological tests such as Antinuclear Antibodies and Schistosoma Antibodies. The patient was kept on valsartan and Bisoprolol with oral anticoagulant (vitamin K antagonist) and Rosuvastatin. EMF may have a heterogeneous presentation and should be considered in a patient with calcific apical thrombus without previous history of cardiac problem, even in the non\u2010tropical region.<\/jats:p>","DOI":"10.1002\/ccr3.5021","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T04:55:56Z","timestamp":1653281756000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endomyocardial fibrosis in a non\u2010tropical patient who presented with chest pain mimicking ACS and left ventricular thrombus, case report"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7091-310X","authenticated-orcid":false,"given":"Ahmad S.","family":"Matarneh","sequence":"first","affiliation":[{"name":"Internal Medicine Department of Medical Education Hamad Medical Corporation (HMC)  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0760-9906","authenticated-orcid":false,"given":"Yousef M. Ali","family":"Hailan","sequence":"additional","affiliation":[{"name":"Internal Medicine Department of Medical Education Hamad Medical Corporation (HMC)  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabir","family":"Abdul Karim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Hospital HMC  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam\u00a0A.","family":"Al Kuwari","sequence":"additional","affiliation":[{"name":"Heart Hospital HMC  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wafer A.","family":"Dabdoob","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Hospital HMC  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,23]]},"reference":[{"volume-title":"Endomyocardial Fibrosis","year":"2020","author":"Bhatti K","key":"e_1_2_10_2_1"},{"key":"e_1_2_10_3_1","first-page":"1","article-title":"Endomyocardial fibrosis: diagnosis and management","volume":"8","author":"Khalil SI","year":"2020","journal-title":"J Vasc Diagn Interv"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-019-1244-3"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43044-019-0027-x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.4322\/acr.2017.024"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.31.329"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.38.4.369"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(00)70008-3"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2009.03.091"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2020190148"},{"issue":"1","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1136\/ha.2010.003525","article-title":"The medical treatment of endomyocardial fibrosis in 2009","volume":"3","author":"Subair KM","year":"2011","journal-title":"Heart Asia"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(99)00027-5"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2016.08.005"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.5021","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.5021","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.5021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T04:23:07Z","timestamp":1764476587000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.5021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1002\/ccr3.5021"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.5021","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2022,5]]},"assertion":[{"value":"2021-09-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e05021"}}