Cardiac diseases in AIDS medical therapy: Difference between revisions

Jump to navigation Jump to search
Line 5: Line 5:
==Medical Therapy==
==Medical Therapy==
===Pericarditis===
===Pericarditis===
Majority of the [[AIDS]] patients with [[pericarditis]] are asymptomatic. Small [[pericardial effusion]]s without [[tamponade]] can be followed up without any further testing. In symptomatic patients with large effusions with or without a tamponade, [[pericardiocentesis]] is indicated to obtain culture and cytology <ref name="pmid8017317">{{cite journal |author=Hsia J, Ross AM |title=Pericardial effusion and pericardiocentesis in human immunodeficiency virus infection |journal=[[The American Journal of Cardiology]] |volume=74 |issue=1 |pages=94–6 |year=1994 |month=July |pmid=8017317 |doi= |url=}}</ref>. If tamponade occurs, immediate drainage is necessary.  
Majority of the [[AIDS]] patients with [[pericarditis]] are asymptomatic. Small [[pericardial effusion]]s without [[tamponade]] can be followed up without any further testing. In symptomatic patients with large effusions with or without a tamponade, [[pericardiocentesis]] is indicated to obtain culture and cytology <ref name="pmid8017317">{{cite journal |author=Hsia J, Ross AM |title=Pericardial effusion and pericardiocentesis in human immunodeficiency virus infection |journal=[[The American Journal of Cardiology]] |volume=74 |issue=1 |pages=94–6 |year=1994 |month=July |pmid=8017317 |doi= |url=}}</ref>. If tamponade occurs, immediate drainage is necessary <ref name="pmid10047635">{{cite journal |author=Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M |title=Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature |journal=[[American Heart Journal]] |volume=137 |issue=3 |pages=516–21 |year=1999 |month=March |pmid=10047635 |doi= |url=}}</ref>.  


It is recommended that patients with pericarditis of unknown etiology be treated emperically for ''[[Mycobacterium tuberculosis]]''. Addition of [[perdnisolone]] to anti-tubercular therapy is associated with rapid recovery, lower mortality rates and decreased need for surgical intervention.  
It is recommended that patients with pericarditis of unknown etiology be treated emperically for ''[[Mycobacterium tuberculosis]]''. Addition of [[perdnisolone]] to anti-tubercular therapy is associated with rapid recovery, lower mortality rates and decreased need for surgical intervention.  

Revision as of 19:07, 1 July 2013

Cardiac diseases in AIDS Microchapters

Home

Overview

Pathophysiology

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Echocardiography

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Cardiac diseases in AIDS medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

slides

Images

American Roentgen Ray Society Images of Cardiac diseases in AIDS medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Cardiac diseases in AIDS medical therapy

CDC on Cardiac diseases in AIDS medical therapy

Cardiac diseases in AIDS medical therapy in the news

Blogs on Cardiac diseases in AIDS medical therapy

Directions to Hospitals Treating Cardiac diseases in AIDS

Risk calculators and risk factors for Cardiac diseases in AIDS medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Medical Therapy

Pericarditis

Majority of the AIDS patients with pericarditis are asymptomatic. Small pericardial effusions without tamponade can be followed up without any further testing. In symptomatic patients with large effusions with or without a tamponade, pericardiocentesis is indicated to obtain culture and cytology [1]. If tamponade occurs, immediate drainage is necessary [2].

It is recommended that patients with pericarditis of unknown etiology be treated emperically for Mycobacterium tuberculosis. Addition of perdnisolone to anti-tubercular therapy is associated with rapid recovery, lower mortality rates and decreased need for surgical intervention.

Bacterial and fungal causes of pericarditis are treated with appropriate anti-bacterials and anti-fungals.

Pericarditis secondary to lymphoma can be treated with radiation and/or chemotherapy. However, combination chemotherapy has been shown to significantly increase the risk of early death from opportunistic infections.

Heart Failure

Treatment of heart failure in patients with AIDS is similar to that of in general population. ACE inhibitors, diuretics, beta-blockers and digoxin are indicated as usual. Also, drugs that are known to cause cardiac side effects should be discontinued.

Lifestyle modification (smoking cessation, weight reduction) and control of hypertension, diabetes and elevated cholesterol should be paid special attention.

Cardiac Tumors

Chemotherapy and radiation therapy have been shown to have a variable effect in the treatment of primary cardiac lymphoma [3].

References

  1. Hsia J, Ross AM (1994). "Pericardial effusion and pericardiocentesis in human immunodeficiency virus infection". The American Journal of Cardiology. 74 (1): 94–6. PMID 8017317. Unknown parameter |month= ignored (help)
  2. Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M (1999). "Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature". American Heart Journal. 137 (3): 516–21. PMID 10047635. Unknown parameter |month= ignored (help)
  3. Montalbetti L, Della Volpe A, Airaghi ML, Landoni C, Brambilla-Pisoni G, Pozzi S (1999). "Primary cardiac lymphoma. A case report and review". Minerva Cardioangiologica. 47 (5): 175–82. PMID 10479855. Unknown parameter |month= ignored (help)


Template:WikiDoc Sources