Endocardial fibroelastosis (EFE) is a rare heart disorder usually occurring in children two years old and younger. It may also be considered a reaction to stress, not necessarily a specific disease.It should not be confused with endomyocardial fibrosis. Signs and symptoms
EFE is characterized by a thickening of the innermost lining of the heart chambers (the endocardium) due to an increase in the amount of supporting connective tissue and elastic fibres. It is an uncommon cause of unexplained heart failure in infants and children, and is one component of HEC syndrome. Fibroelastosis is strongly seen as a primary cause of restrictive cardiomyopathy in children, along with cardiac amyloidosis, which is more commonly seen in progressive multiple myeloma patients and the elderly. Cause
A review cites references to 31 different diseases and other stresses associated with the EFE reaction. These include infections, cardiomyopathies, immunologic diseases, congenital malformations, even electrocution by lightning strike. EFE has two distinct genetic forms, each having a different mode of inheritance. An X-linked recessive form, and an autosomal recessive form have both been observed. Diagnosis
Treatment
The cause should be identified and, where possible, the treatment should be directed to that cause. A last resort form of treatment is heart transplant. History
An infant with dilated, failing heart was no rarity on the pediatric wards of hospitals in the mid-twentieth century. On autopsy, most of these patients hearts showed the thickened endocardial layer noted above.
Ataque de nervios (Spanish pronunciation: [aˈtake ðe ˈneɾβjos], also known as "Puerto Rican syndrome") is a psychological syndrome mostly associated, in the United States, with Spanish-speaking people from the Caribbean, although commonly identified among all Iberian-descended cultures. Ataque de nervios translates into English as "attack of nerves", although it is used in its common cultural form to refer to a specific pattern of symptoms, rather than being a general term for feeling nervous. The condition appears in Appendix I of the revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as a culture-bound syndrome. Classification
Despite comparisons to panic attacks, investigators have identified ataque de nervios as a separate syndrome with measured differences in anxiety sensitivity, and types of attacks. Marlene Steinberg, an Associate Research Scientist at Yale University stated that because it is similar to Multiple Personality Disorder, some Hispanics may be misdiagnosed with an ataque de nervios syndrome instead. Symptoms
Reported aspects of the syndrome include uncontrollable screaming or shouting, crying, trembling, sensations of heat rising in the chest and head, dissociative experiences, and verbal or physical aggression. The reaction is usually associated with a stressful event relating to the family, although it is not specifically defined as arising from such occurrences. History
Ataque de nervios was first mentioned after studies were conducted by US psychiatrists who focused on healthcare for Hispanic populations, particularly individuals who were Puerto Rican and living in the United States . See also
Dissociative identity disorder
Nervous breakdown
Susto
Women on the Verge of a Nervous Breakdown
Hwabyeong
Posttraumatic stress disorder


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