[Phonocardiographic and mechanographic study of 12 cases of constrictive endocardial fibrosis (or endomyocardial fibrosis)].

A phonomechanographic study of 12 patients with restrictive endomyocardial fibrosis (EMF) has highlighted the essential criteria for the diagnosis of this condition. The "ventricular" type of JVP, with a dip-plateau, is a reliable sign of right-sided EMF; this sign is more rarely of the tricuspid incompetence type. A similar picture emerges from recordings of hepatic pulsation, or other venous pulses. An apex-cardiogram with a dip-plateau is in favour of the diagnosis of left-sided EMF. The finding of a recordable infundibular impulse supports a left-sided EMF. Demonstration of an early-diastolic thrill, of endocardial origin, is an essential feature of this condition. It coincides with the rising phase of the dip, and was found in 10 of our 12 cases. There may also be murmurs arising from the pulmonary and atrio-ventricular valves. The characteristic feature of the carotid tracing is a prolonged pulse wave, with corresponding reduction of the haemodynamic quotient. These signs result from contraction of the potential filling space of the ventricle, from the restricted movement of the atrio-ventricular valves, and from a reduced blood flow.