Joshi S, Deshpande AK; International Conference on AIDS.
Int Conf AIDS. 1998; 12: 575 (abstract no. 32278).
Medicine Dept., GMC & SIRJJH, Mumbai, India.
BACKGROUND: The present study was due to decide the nature and extent of cardiac involvement in HIV infected cases. Apart from clinical presentation, it also looked at prevalence of myocardial dysfunction aided by echo cardiography and later after death at necropsy. METHODS: 74 Consecutive HIV positive Indian Cases were prospectively evaluated from July 1991 till January 1998. Survivors were grouped as Group I and those dead and necropsied as Group II. Apart from standard clinical, biochemical, hematological & body fluid analysis, investigations; all cases were subjected to EKG, CXR, Echocardiography (M-mode, 2-D & Doppler) and later at necropsy special attention was given to cardiac histopathology. RESULTS: The age group ranged from 17 to 52 years with mean age 29.8 yrs, predominant patients belong to the 3rd (51.35%) & 4th (33.8%) decade, with a male female ratio of 5.7:1, 58.1% were heterosexuals, 4.05% transfusion related, 2.7% i.v. Drug abusers, 1.35% bisexuals and 20.27% had multiple risk factors. 52.7% had STD/GUD; only 12.16% VDRL positive and 1.37% UbsAg positive. Radiology revealed cardiomegaly in 24.32% & 20.27% had abnormal electrocardiograms. Echocardiogram revealed 10.6% had Dilated Cardiomyopathy, 8.5% had pericardial effusion, 4.2% vegetations, 2.1% constrictive pericarditions & 10.6% incidental valvular, LVH & IHD. Diastolic dysfunction was observed in 60% of cases. Group I revealed 25.6% cases and Group II 41.93% cases with major cardiac involvement. At necropsy 41.9% had cardiac histopathological changes 25.8% had pericardial, 12.9% myocardial while 6.45% had other forms of cardiac pathology. 16.2% had pericardial involvement of 4.05% presented as cardiac tamponade with 1.35% moderate pericardial effusion. 9.4% had presumptive tubercular involvement, 2.7% had cryptococcal and I each had fibrinous pyogenic & constrictive pericarditis. 12.6% had myocardial involvement. 6.7% presenting as dilated cardiomyopathy and 2.07% were found on histopathology. On necropsy 1.35% showed evidence of cryptococcal myocarditis and additional lymphocytic myocarditis. 2.7% had endocardial involvement. Both presenting as endocarditis and being i.v. drug abusers. CONCLUSIONS: Cardiac dysfunction is now being recognised among Indian HIV infected and AIDS cases. Though primary manifestation is uncommon pericardial involvement presenting as cardiac tamponade and myocardial involvement presenting as congestive cardiomypathy is now being seen. Also associated cardiac finding are commonly seen both clinically and at autopsy. Early detection of cardiac dysfunction by echocardiogram may well be necessary in future as the clinical spectrum fully evolves to detect early myocardial dysfunction.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Cardiac Tamponade
- Cardiomyopathies
- Cardiomyopathy, Dilated
- Echocardiography
- Female
- HIV
- HIV Infections
- HIV Seropositivity
- Heart
- Heart Diseases
- Humans
- Male
- Myocarditis
- Myocardium
- Pericardial Effusion
- Pericarditis, Constrictive
- Pericardium
- Population
- Population Groups
- Prevalence
- Risk Factors
- ultrasonography
Other ID:
UI: 102229793
From Meeting Abstracts