Endomyocardial Fibrosis and the Prothrombotic State: From Hypercoagualability to Protien C Deficiency

Thrombosis and endomyocardial fibrosis have coexisted for a long time. Earlier authors like Shaper, De Arbela and Davies have commented on the prevalence of large intracardiac thrombi in endomyocardial fibrosis. In three different reports Gupta PN, has also commented on intracardiac thrombi and their sequelae as thromboembolism in the past. We review here the possibility that apart from the basic intracavitary stasis due to chamber dilatation there may be an additional haematological defect in endomyocardial fibrosis. We review our previous studies on Protein C in endomyocardial fibrosis and the reduced platelet aggregation with collagen (but normal aggregation with ADP) that we had seen in our endomyocardial fibrosis patients. We postulated that these defects would add to the intracardiac thrombosis seen in endomyocardial fibrosis