Endocardial fibroelastosis

Last revised by Joachim Feger on 29 Apr 2021

Endocardial fibroelastosis (EFE) is a rare cardiac condition which is classically described in the pediatric population (typically first two years). It is one of the causes in infants of unexplained heart failure.

The condition results from increasing amounts of fibrous and elastic tissue affecting the endocardium as well as the subendocardium. This then causes diffuse thickening with subsequent impairment of myocardial contractility. 

Echocardiography may show:

Cardiac MRI might show:

  • endocardial thickening
  • apical filling defect
  • atrial or ventricular thrombus formation
  • diffuse endocardial late gadolinium enhancement 

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