A disease that has a skyrocket mortality and that is the fourth most common heart disease are problems by the disease, endomyocardial fibrosis. This disease is commonly found in tropical regions, and is commonly found in Africa. The disease is characterized by the scarring and unusual amount of thickening of the connective tissue of the left and right ventricles of the heart. The big problem with this disease physiologically is that it causes restrictive ventricular filling. This disease causes death in places that are struck with poverty and has bad health care. Unfortunately, most who have this disease live up to two years. This problem is the cause of twenty-five percent of heart failures in equatorial Africa. There are many potential causes that have been collected through a group of studies. Overall, there are four types of causes: infectious, environmental exposure, immunological, and genetic. Some infections include rheumatic fever, malaria, and some helminthic parasites. Some environmental causes includes ingesting food and using contaminated soil with significant levels of cesium. The immunological cause could be the presence of anti-myosin autoantibodies, and there could also be a genetic cause because there have been many cases of  the disease being inherited. The disease causes the damage of the endocardium and restricts the blood to fill the left and right ventricles back up with blood during a diastole. If there is not enough blood, when it comes to the asystole, the heart will not be able to pump the necessary amount of blood out into the ventricles. The heart can only take this for about two years at which point heart failure will occur and cause the patient to die.

            The purpose of  the study was to find out the physiological cause of this disease so physicians can catch it early. This was important because before this, cases that were recorded generally included patients who got it spontaneously and were diagnosed at the later stages. This was not good because there were more and more people that were dying from this disease, and the high mortality and spontaneity of the condition called for not a lot of attention from the physicians of the country where the suffering first was which was Africa. This was due to poverty; however, once it occurred in India it was finally documented and research started. The hypothesis was that if there was endocardial involvement and intracardiac thrombi, then there has to be a problem with the ventricles. Key terms used in this research study are fibrosis, ventricle, echocardiography, eosinophilia, cardiomyopathy, and acute. Fibrosis is the thickening and scarring of connective tissue. A ventricle is one of the four chambers in the heart that collects and expels blood received from an atrium toward the body and lungs. An echocardiogram is test that uses high-pitched sound waves and the Doppler ultrasound to create images of the heart. Eosinophil is a type of disease-fighting white blood cell, and having eosinophilia most often indicates a parasitic infection, an allergic reaction or cancer. A cardiomyopathy is an acquired or hereditary disease of heart muscle, this condition makes it hard for the heart to deliver blood to the body, and can lead to heart failure. Acute means that the disease lasts for a short period of time.

          With the study of the different patients autopsies, there was the establishment of three stages that the patients with this disease would go through. The method was with the patients going through the three phases. The initial phase was an acute carditis phase, that caused febrile illness and in severe cases with heart failure and shock. Then those who survived the acute illness progressed into a sub acute phase followed by a chronic phase (most of the patients then came to clinical attention in this chronic burnt-out phase).This was an original study and was the first to be done which resulted in the first report of the disease in Southern India. Tools used in this study were echocardiograms that use the Doppler ultrasound to see the cross-sectional view of the heart. There were not really any variables in this study because it was not an experiment rather than an observational study. The sampling performed were patients that had the disease. This was sampling of the people of a certain geographic region.

           After long years of cultivating data and performing tests a conclusion was reached. The physiological cause of the cardiomyopathic disease, endomyocardial fibrosis, had a simple answer. Turns out that the cause of the fibrosis of the ventricles which causes either the left or right ventricle to be inflamed and create a thick “skin” of sorts around the ventricle to not retain enough blood means that the heart cannot pump enough blood throughout the body. The effects were also found out through ECGs that the heart experiences mitral regurgitation, right atrial enlargement, tricuspid regurgitation, and a restrictive type flow pattern. These finding are important in treating patients with this condition. Although there is no cure for this heart disease like many other cardiac diseases, the finding of these results significantly helped the medical community reduce the number of deaths from this disease.