Endomyocardial fibrosis presenting outside the tropical rain forest.

Endomyocardial fibrosis (EMF), an idiopathic cardiac disorder, occurs predominantly in the tropical and subtropical regions of the world. We present herein a report of EMF in a young man from the savannah belt of Nigeria. He was a 19-year-old young man who presented with recent onset of palpitation and dyspnea and was followed up elsewhere for 3 years as a case of chronic liver disease due to progressive abdominal distension. Clinical examination revealed an undernourished young man with atrial fibrillation and features of heart failure. His electrocardiogram showed features of atrial fibrillation, while echocardiogram showed enlarged right atrium, tricuspid incompetence, and signs of fibrosis in the ventricles. Although EMF occurs primarily in the subtropical regions of Africa in its typical manifestation, in this report it was in the savannah belt.