Endomyocardial fibrosis was diagnosed in a 30-year-old Ghanese woman suffering from heart failure and intracardial thrombi. Endomyocardial fibrosis is an endemic disease in tropical countries with a high mortality rate. Since the aetiology of this disease is still unknown, patients can only be treated symptomatically. Endocardial and myocardial damage give rise to reactive fibrosis, subendocardial infarction and thrombus formation, resulting in heart failure and thromboembolic processes.