Endocardial fibroelastosis

Endocardial fibroelastosis (EFE) is a rare cardiac condition which is classically described in the paediatric population (typically ~ 1st two years). It is one of the causes for infants to present with unexplained heart failure.


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

Radiographic features

Ultrasound / Echocardiography

* may show a strongly echogenic myocardium 3
* may also show ancillary features such as cardiomegaly and evidence of hydrops fetalis as a result of cardiac failure.


* mitral valve abnormalities : e.g mitral regurgitation

Article Author : Dr Yuranga Weerakkody, Radiopaedia


* 1. JP McGahan et.al, Sonography of the fetal heart: findings on the four-chamber view, AJR, 156, 547-553, 1991
* 2. Fetal endocardial fibroelastosis: ultrasonographic findings in two cases Tannouri et al. J Ultrasound Med.1998; 17: 63-66
* 3. Weiner, Zeev MD; Shalev, Eliezer MD, Case Reports Doppler Fetal Echocardiography in Endocardial Fibroelastosis, Obstetrics & Gynecology: November 2001 - Volume 98 - Issue 5, Part 2 - p 933-935
* 4. Soon Yong Suha et.al, Endocardial fibroelastosis demonstrated on multidetector computed tomography, Volume 124, Issue 3, Pages e51-e52 (14 March 2008)
* 5. Lynne E. Nield, MD et.al, CLINICAL STUDY: ENDOCARDIAL FIBROELASTOSIS, Endocardial fibroelastosis associated with maternal anti-Ro and anti-La antibodies in the absence of atrioventricular block, J Am Coll Cardiol, 2002; 40:796-802

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