Migratory Flows and Endomyocardial Fibrosis: A Mysterious Disease in Western Countries

Background—Endomyocardial fibrosis (EMF) is a chronic restrictive cardiomyopathy endemic to tropical and subtropical regions, characterized by fibrotic thickening of the endocardium, predominantly affecting the ventricular chambers. As global migration increases, cases of EMF may emerge in non-endemic areas, posing a diagnostic challenge for healthcare professionals unfamiliar with this condition. Methods—We report the case of a 21-year-old man of African origin who experienced sudden collapse while residing in a reception center for asylum seekers in Apulia, Southeastern Italy. His medical history revealed that one week prior, he had been presented with high fever, chest pain, and asthenia, symptoms initially misinterpreted as influenza by a local physician, leading to antibiotic therapy. Results—The definitive diagnosis of EMF was established post-mortem through histological examination, which identified characteristic endocardial fibrosis. This case exemplifies the re-emergence of neglected tropical cardiac diseases in Western countries due to increased migration from endemic regions. Conclusions—This case highlights the need for heightened clinical awareness among healthcare professionals, particularly in cardiology and primary care, to recognize and manage geographically displaced diseases such as EMF. Implementing enhanced medical education and diagnostic protocols is essential to address the evolving epidemiological landscape and improve early identification of rare but significant cardiac pathologies in migrant populations.