HIV induced pericarditis: Difference between revisions

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__NOTOC__
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{{Pericarditis}}
{{HIV induced pericarditis}}
'''For patient information, click [[HIV induced pericarditis (patient information)|here]]'''


{{CMG}}; '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.
{{CMG}}; {{AE}} {{RG}}


==Overview==
{{SK}}


A wide variety of cardiovascular complications are seen in advanced [[HIV]] infected patients. The most common are:
==[[HIV induced pericarditis overview|Overview]]==
:*[[Pericarditis]] <ref name="pmid3181175">Corallo S, Mutinelli MR, Moroni M, Lazzarin A, Celano V, Repossini A et al. (1988) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=3181175 Echocardiography detects myocardial damage in AIDS: prospective study in 102 patients.] ''Eur Heart J'' 9 (8):887-92. PMID: [http://pubmed.gov/3181175 3181175]</ref> <ref name="pmid2926051">Himelman RB, Chung WS, Chernoff DN, Schiller NB, Hollander H (1989) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2926051 Cardiac manifestations of human immunodeficiency virus infection: a two-dimensional echocardiographic study.] ''J Am Coll Cardiol'' 13 (5):1030-6. PMID: [http://pubmed.gov/2926051 2926051]</ref> <ref name="pmid1464334">De Castro S, Migliau G, Silvestri A, D'Amati G, Giannantoni P, Cartoni D et al. (1992) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1464334 Heart involvement in AIDS: a prospective study during various stages of the disease.] ''Eur Heart J'' 13 (11):1452-9. PMID: [http://pubmed.gov/1464334 1464334]</ref> <ref name="pmid8017317">Hsia J, Ross AM (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8017317 Pericardial effusion and pericardiocentesis in human immunodeficiency virus infection.] ''Am J Cardiol'' 74 (1):94-6. PMID: [http://pubmed.gov/8017317 8017317]</ref> <ref name="pmid7586308">Heidenreich PA, Eisenberg MJ, Kee LL, Somelofski CA, Hollander H, Schiller NB et al. (1995) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7586308 Pericardial effusion in AIDS. Incidence and survival.] ''Circulation'' 92 (11):3229-34. PMID: [http://pubmed.gov/7586308 7586308]</ref> <ref name="pmid9458682">Estok L, Wallach F (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9458682 Cardiac tamponade in a patient with AIDS: a review of pericardial disease in patients with HIV infection.] ''Mt Sinai J Med'' 65 (1):33-9. PMID: [http://pubmed.gov/9458682 9458682]</ref>
:*[[Myocarditis]]
:*[[Cardiomyopathy]]
:*[[Pulmonary hypertension]]
:*[[Coronary artery disease]]


==Epidemiology and demographics==
==[[HIV induced pericarditis historical perspective|Historical Perspective]]==


Pericardial diseases in the form of [[pericardial effusion]] or [[cardiac tamponade]]<ref name="pmid7586308">{{cite journal| author=Heidenreich PA, Eisenberg MJ, Kee LL, Somelofski CA, Hollander H, Schiller NB et al.| title=Pericardial effusion in AIDS. Incidence and survival. | journal=Circulation | year= 1995 | volume= 92 | issue= 11 | pages= 3229-34 | pmid=7586308 | doi= | pmc= | url= }} </ref><ref name="pmid2721281">{{cite journal| author=Stotka JL, Good CB, Downer WR, Kapoor WN| title=Pericardial effusion and tamponade due to Kaposi's sarcoma in acquired immunodeficiency syndrome. | journal=Chest | year= 1989 | volume= 95 | issue= 6 | pages= 1359-61 | pmid=2721281 | doi= | pmc= | url= }} </ref><ref name="pmid1582323">{{cite journal| author=Karve MM, Murali MR, Shah HM, Phelps KR| title=Rapid evolution of cardiac tamponade due to bacterial pericarditis in two patients with HIV-1 infection. | journal=Chest | year= 1992 | volume= 101 | issue= 5 | pages= 1461-3 | pmid=1582323 | doi= | pmc= | url= }} </ref><ref name="pmid10047635">Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10047635 Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature.] ''Am Heart J'' 137 (3):516-21. PMID: [http://pubmed.gov/10047635 10047635]</ref> have been recognized as a complication since HIV infection was first reported in 1981.
==[[HIV induced pericarditis classification|Classification]]==


*In a small autopsy study, '''24% cases''' reported major cardiac pathology <ref name="pmid3973269">{{cite journal| author=Cammarosano C, Lewis W| title=Cardiac lesions in acquired immune deficiency syndrome (AIDS). | journal=J Am Coll Cardiol | year= 1985 | volume= 5 | issue= 3 | pages= 703-6 | pmid=3973269 | doi= | pmc= | url= }} </ref>.
==[[HIV induced pericarditis pathophysiology|Pathophysiology]]==


*The incidence of [[pericardial effusion]] in patients with asymptomatic AIDS was '''11% per year before''' the introduction of effective [[highly active antiretroviral therapy]] (HAART). The 6 month survival rate of AIDS patients with effusion was significantly shorter (36%) than the survival rate without effusions (93%). This shortened survival rate remained statistically significant after adjustment for lead-time bias and was independent of [[CD4 count]] and albumin level<ref name="pmid7586308">{{cite journal| author=Heidenreich PA, Eisenberg MJ, Kee LL, Somelofski CA, Hollander H, Schiller NB et al.| title=Pericardial effusion in AIDS. Incidence and survival. | journal=Circulation | year= 1995 | volume= 92 | issue= 11 | pages= 3229-34 | pmid=7586308 | doi= | pmc= | url= }} </ref>.
==[[HIV induced pericarditis causes|Causes]]==


*The incidence of AIDS-related cardiac disease is very high in Africa in comparison to that seen in the developed countries. In the period from 1993 to 1999 in Burkina Faso, '''79%''' of AIDS patients exhibited cardiac involvement, whereas in an Italian study in the period from 1992 to 1995, the incidence of AIDS-related cardiac disease was '''6.5%'''<ref name="pmid15124176">{{cite journal| author=Pugliese A, Gennero L, Vidotto V, Beltramo T, Petrini S, Torre D| title=A review of cardiovascular complications accompanying AIDS. | journal=Cell Biochem Funct | year= 2004 | volume= 22 | issue= 3 | pages= 137-41 | pmid=15124176 | doi=10.1002/cbf.1095 | pmc= | url= }} </ref>.
==[[HIV induced pericarditis differential diagnosis|Differentiating HIV induced pericarditis from other Diseases]]==


==Pathophysiology==
==[[HIV induced pericarditis epidemiology and demographics|Epidemiology and Demographics]]==
Patients with advanced [[HIV]] have pericardial involvement at some point and the most common abnormality is [[pericardial effusion]]<ref name="pmid14533546">{{cite journal| author=Barbaro G| title=Pathogenesis of HIV-associated cardiovascular disease. | journal=Adv Cardiol | year= 2003 | volume= 40 | issue=  | pages= 49-70 | pmid=14533546 | doi= | pmc= | url= }} </ref>.


:*Asymptomatic effusions are mostly small and '''idiopathic'''.
==[[HIV induced pericarditis risk factors|Risk Factors]]==
:*In advanced HIV disease, effusions are a part of '''generalized seroeffusive process''' involving pleural and peritoneal surfaces, possibly related to enhanced cytokine expression, resulting in moderate to large effusions.
:*[[Congestive heart failure]], [[Kaposi sarcoma]], and [[Tuberculosis]] are '''independently''' associated with moderate to large effusions.


==Etiology==
==[[HIV induced pericarditis screening|Screening]]==
It is often difficult to identify the etiology of [[pericardial effusion]] in HIV-infected patients.
The common organisms isolated are:
:*[[Mycobacterium tuberculosis]] which is the most common etiology for pericardial effusion in African HIV-infected patients<ref name="pmid16330703">{{cite journal| author=Mayosi BM, Burgess LJ, Doubell AF| title=Tuberculous pericarditis. | journal=Circulation | year= 2005 | volume= 112 | issue= 23 | pages= 3608-16 | pmid=16330703 | doi=10.1161/CIRCULATIONAHA.105.543066 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16330703  }} </ref><ref name="pmid16781213">{{cite journal| author=Sudano I, Spieker LE, Noll G, Corti R, Weber R, Lüscher TF| title=Cardiovascular disease in HIV infection. | journal=Am Heart J | year= 2006 | volume= 151 | issue= 6 | pages= 1147-55 | pmid=16781213 | doi=10.1016/j.ahj.2005.07.030 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16781213  }} </ref>
:*[[Staphylococcus aureus]] <ref name="pmid3467225">Stechel RP, Cooper DJ, Greenspan J, Pizzarello RA, Tenenbaum MJ (1986) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=3467225 Staphylococcal pericarditis in a homosexual patient with AIDS-related complex.] ''N Y State J Med'' 86 (11):592-3. PMID: [http://pubmed.gov/3467225 3467225]</ref> <ref name="pmid8306779">Decker CF, Tuazon CU (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8306779 Staphylococcus aureus pericarditis in HIV-infected patients.] ''Chest'' 105 (2):615-6. PMID: [http://pubmed.gov/8306779 8306779]</ref>
:*[[Cryptococcus neoformans]] <ref name="pmid4045235">Schuster M, Valentine F, Holzman R (1985) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=4045235 Cryptococcal pericarditis in an intravenous drug abuser.] ''J Infect Dis'' 152 (4):842. PMID: [http://pubmed.gov/4045235 4045235]</ref>
:*[[Herpes simplex]] <ref name="pmid3035442">Freedberg RS, Gindea AJ, Dieterich DT, Greene JB (1987) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=3035442 Herpes simplex pericarditis in AIDS.] ''N Y State J Med'' 87 (5):304-6. PMID: [http://pubmed.gov/3035442 3035442]</ref>


'''Supportive trial data:'''
==[[HIV induced pericarditis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
*A retrospective study <ref name="pmid7781340">Flum DR, McGinn JT, Tyras DH (1995) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7781340 The role of the 'pericardial window' in AIDS.] ''Chest'' 107 (6):1522-5. PMID: [http://pubmed.gov/7781340 7781340]</ref> of 29 patients with AIDS-related pericardial effusion who underwent fluid cultures and pericardial biopsy, etiology was established only in 7% patients. The causes included:
::*Mycobacterium tuberculosis (1%),
::*Staphylococcus aureus(1%), and  
::*Neoplasms (2% adenocarcinoma and 3% [[lymphoma]])
 
*Another study that evaluated pericardial effusions in 17 patients with HIV <ref name="pmid8017317">Hsia J, Ross AM (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8017317 Pericardial effusion and pericardiocentesis in human immunodeficiency virus infection.] ''Am J Cardiol'' 74 (1):94-6. PMID: [http://pubmed.gov/8017317 8017317]</ref>, revealed etiologic evidence in 5 patients of which 2 were found to have lymphoma, and 1 each had staphylococcus aureus, mycobacterium tuberculosis, and fungal infection.


==Diagnosis==
==Diagnosis==
 
[[HIV induced pericarditis diagnostic study of choice|Diagnostic study of choice]] | [[HIV induced pericarditis history and symptoms|History and Symptoms]] | [[HIV induced pericarditis physical examination|Physical Examination]] | [[HIV induced pericarditis laboratory findings|Laboratory Findings]] | [[HIV induced pericarditis electrocardiogram|Electrocardiogram]] | [[HIV induced pericarditis x ray|X-Ray Findings]] | [[HIV induced pericarditis echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[HIV induced pericarditis CT scan|CT-Scan Findings]] | [[HIV induced pericarditis MRI|MRI Findings]] | [[HIV induced pericarditis other imaging findings|Other Imaging Findings]] | [[HIV induced pericarditis other diagnostic studies|Other Diagnostic Studies]]
====History and symptoms:====
The frequency and severity of the symptoms varies with the stage of infection and the degree [[pericardium|pericardial]] involvement.
 
*Majority of the patients are '''asymptomatic''' and present with an increase in the cardiac silhouette on chest x-ray.
 
*Symptomatic patients present with the following:
::*[[Chest pain]]: characteristically sharp and pleuritic in nature, exacerbated by inspiration and relieved by sitting up and leaning forward.
::*[[breathlessness]]
::*[[Malaise]]
::*[[Fever]]
::*[[Cough]]
::*[[Ankle edema]] and/or [[ascites]]
 
====Physical Examination:====
 
'''Vitals:'''
 
*[[Tachycardia]],
 
*[[pulsus paradoxus]] and
 
*[[hypotension]] (in [[cardiac tamponade]]),
 
'''Neck:'''
 
*[[Jugular venous distension]] with a prominent Y descent and [[Kussmaul's sign]] may be present.
<youtube v=uB1c2zvkaew/>
 
'''Chest:'''
 
*[[Ewart's sign]]: Dullness to percussion beneath the angle of left scapula from compression of the left lung by pericardial fluid may be present.
 
*'''Pericardial knock'''
 
<youtube v=Jtk2vVgQuU0/>
 
*'''[[Pericardial rub]]'''
 
<youtube v=EUCp_3_vwtw/>
 
'''Abdomen:'''
*[[Hepatomegaly]]
 
*[[ascites]]
 
*[[Hepatojugular reflux]] may be present
<youtube v=B8OX3T4c7PU/>>
 
'''Extremities:''' [[Ankle edema]]
 
====CXR:====
 
====Electrocardiogram:====
 
====Echocardiography:====
Approximately one third of the patients with symptomatic [[pericardial effusion]] can develop [[cardiac tamponade]].<ref name="pmid10047635">Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10047635 Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature.] ''Am Heart J'' 137 (3):516-21. PMID: [http://pubmed.gov/10047635 10047635]</ref> The echocardiogram below  demonstrates '''swinging motion of the heart''' in [[cardiac tamponade]].
<youtube v=U4xQ3-VRiNg/>


==Treatment==
==Treatment==
[[HIV induced pericarditis medical therapy|Medical Therapy]] | [[HIV induced pericarditis interventions|Interventions]] | [[HIV induced pericarditis surgery|Surgery]] | [[HIV induced pericarditis primary prevention|Primary Prevention]] | [[HIV induced pericarditis secondary prevention|Secondary Prevention]] | [[HIV induced pericarditis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[HIV induced pericarditis future or investigational therapies|Future or Investigational Therapies]]


*'''Asymptomatic with mild to moderate pericardial effusion:'''
==Case Studies==
::*usually idiopathic and will resolve spontaneously.
[[HIV induced pericarditis case study one|Case #1]]
::*However, asymptomatic effusions in [[HIV]] occurs in advanced stages of the disease or heralds the onset of full-blown AIDS and hence requires treatment to improve survival.<ref name="pmid14533546">Barbaro G (2003) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=14533546 Pathogenesis of HIV-associated cardiovascular disease.] ''Adv Cardiol'' 40 ():49-70. PMID: [http://pubmed.gov/14533546 14533546]</ref> [[HAART]] therapy has significantly reduced the incidence and severity of cardiac complications associated with [[HIV]].<ref name="pmid16330702">Ntsekhe M, Hakim J (2005) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16330702 Impact of human immunodeficiency virus infection on cardiovascular disease in Africa.] ''Circulation'' 112 (23):3602-7. [http://dx.doi.org/10.1161/CIRCULATIONAHA.105.549220 DOI:10.1161/CIRCULATIONAHA.105.549220] PMID: [http://pubmed.gov/16330702 16330702]</ref> <ref name="pmid16781213">Sudano I, Spieker LE, Noll G, Corti R, Weber R, Lüscher TF (2006) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16781213 Cardiovascular disease in HIV infection.] ''Am Heart J'' 151 (6):1147-55. [http://dx.doi.org/10.1016/j.ahj.2005.07.030 DOI:10.1016/j.ahj.2005.07.030] PMID: [http://pubmed.gov/16781213 16781213]</ref>
 
*'''Symptomatic large effusions even without [[cardiac tamponade]]:''' require [[pericardiocentesis]] and obtain cultures, cytology to identify the possible etiology.
 
*'''Pericarditis with [[cardiac tamponade]]:''' occurs in 33-40% patients.<ref name="pmid10047635">Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10047635 Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature.] ''Am Heart J'' 137 (3):516-21. PMID: [http://pubmed.gov/10047635 10047635]</ref> This warrants immediate [[pericardiocentesis]] and a catheter is left in the pericardial sac to drain fluid by underwater-seal suction for the next 48 hours.
 
*'''Recurrent pericardial effusion:''' Either subxiphoid pericardiotomy with creation of a pericardial window <ref name="pmid7781340">Flum DR, McGinn JT, Tyras DH (1995) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7781340 The role of the 'pericardial window' in AIDS.] ''Chest'' 107 (6):1522-5. PMID: [http://pubmed.gov/7781340 7781340]</ref> <ref name="pmid9583822">Gouny P, Lancelin C, Girard PM, Hocquet-Cheynel C, Rozenbaum W, Nussaume O (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9583822 Pericardial effusion and AIDS: benefits of surgical drainage.] ''Eur J Cardiothorac Surg'' 13 (2):165-9. PMID: [http://pubmed.gov/9583822 9583822]</ref> or balloon pericardiotomy can be considered.<ref name="pmid8417048">Ziskind AA, Pearce AC, Lemmon CC, Burstein S, Gimple LW, Herrmann HC et al. (1993) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8417048 Percutaneous balloon pericardiotomy for the treatment of cardiac tamponade and large pericardial effusions: description of technique and report of the first 50 cases.] ''J Am Coll Cardiol'' 21 (1):1-5. PMID: [http://pubmed.gov/8417048 8417048]</ref> <ref name="pmid15662494">Marcy PY, Bondiau PY, Brunner P (2005) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15662494 Percutaneous treatment in patients presenting with malignant cardiac tamponade.] ''Eur Radiol'' 15 (9):2000-9. [http://dx.doi.org/10.1007/s00330-004-2611-y DOI:10.1007/s00330-004-2611-y] PMID: [http://pubmed.gov/15662494 15662494]</ref>
 
*'''Large pericardial effusions with unknown etiology:''' empiric therapy with conventional antituberculous therapy for M.tuberculosis have shown some benefit in patients with AIDS. <ref name="pmid1898769">Small PM, Schecter GF, Goodman PC, Sande MA, Chaisson RE, Hopewell PC (1991) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1898769 Treatment of tuberculosis in patients with advanced human immunodeficiency virus infection.] ''N Engl J Med'' 324 (5):289-94. [http://dx.doi.org/10.1056/NEJM199101313240503 DOI:10.1056/NEJM199101313240503] PMID: [http://pubmed.gov/1898769 1898769]</ref> <ref name="pmid3723722">Sunderam G, McDonald RJ, Maniatis T, Oleske J, Kapila R, Reichman LB (1986) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=3723722 Tuberculosis as a manifestation of the acquired immunodeficiency syndrome (AIDS).] ''JAMA'' 256 (3):362-6. PMID: [http://pubmed.gov/3723722 3723722]</ref> <ref name="pmid17976506">Syed FF, Mayosi BM (2007) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17976506 A modern approach to tuberculous pericarditis.] ''Prog Cardiovasc Dis'' 50 (3):218-36. [http://dx.doi.org/10.1016/j.pcad.2007.03.002 DOI:10.1016/j.pcad.2007.03.002] PMID: [http://pubmed.gov/17976506 17976506]</ref>
 
*'''Other causes''' of pericarditis such as bacterial or fungal infections also should be identified and treated accordingly.
 
*'''Pericarditis due to [[lymphoma]]:''' radiation and chemotherapy have been tried. <ref name="pmid1727539">Levine AM (1992) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1727539 AIDS-associated malignant lymphoma.] ''Med Clin North Am'' 76 (1):253-68. PMID: [http://pubmed.gov/1727539 1727539]</ref> <ref name="pmid17325873">Licci S, Narciso P, Morelli L, Brenna A, Cione A, Abbate I et al. (2007) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17325873 Primary effusion lymphoma in pleural and pericardial cavities with multiple solid nodal and extra-nodal involvement in a human immunodeficiency virus-positive patient.] ''Leuk Lymphoma'' 48 (1):209-11. [http://dx.doi.org/10.1080/10428190601019880 DOI:10.1080/10428190601019880] PMID: [http://pubmed.gov/17325873 17325873]</ref> The response however has been transient <ref name="pmid9760158">Sanna P, Bertoni F, Zucca E, Roggero E, Passega Sidler E, Fiori G et al. (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9760158 Cardiac involvement in HIV-related non-Hodgkin's lymphoma: a case report and short review of the literature.] ''Ann Hematol'' 77 (1-2):75-8. PMID: [http://pubmed.gov/9760158 9760158]</ref> and associated chemotherapy has a significantly increased the risk of death due to opportunistic infections.<ref name="pmid1727539">Levine AM (1992) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1727539 AIDS-associated malignant lymphoma.] ''Med Clin North Am'' 76 (1):253-68. PMID: [http://pubmed.gov/1727539 1727539]</ref> 
 
==Prognosis==
*Pericarditis in patients with [[HIV]] occurs in advanced stages of the disease or heralds the onset of full-blown [[AIDS]] and hence is a '''bad prognostic sign'''. <ref name="pmid7586308">Heidenreich PA, Eisenberg MJ, Kee LL, Somelofski CA, Hollander H, Schiller NB et al. (1995) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7586308 Pericardial effusion in AIDS. Incidence and survival.] ''Circulation'' 92 (11):3229-34. PMID: [http://pubmed.gov/7586308 7586308]</ref> <ref name="pmid12934767">Gowda RM, Khan IA, Mehta NJ, Gowda MR, Sacchi TJ, Vasavada BC (2003) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12934767 Cardiac tamponade in patients with human immunodeficiency virus disease.] ''Angiology'' 54 (4):469-74. PMID: [http://pubmed.gov/12934767 12934767]</ref> <ref name="pmid1826690">Blanchard DG, Hagenhoff C, Chow LC, McCann HA, Dittrich HC (1991) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1826690 Reversibility of cardiac abnormalities in human immunodeficiency virus (HIV)-infected individuals: a serial echocardiographic study.] ''J Am Coll Cardiol'' 17 (6):1270-6. PMID: [http://pubmed.gov/1826690 1826690]</ref> <ref name="pmid9579818">Longo-Mbenza B, Seghers KV, Phuati M, Bikangi FN, Mubagwa K (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9579818 Heart involvement and HIV infection in African patients: determinants of survival.] ''Int J Cardiol'' 64 (1):63-73. PMID: [http://pubmed.gov/9579818 9579818]</ref>
 
*Pericarditis in [[HIV]] patients is also associated with '''shortened survival'''. <ref name="pmid14533546">Barbaro G (2003) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=14533546 Pathogenesis of HIV-associated cardiovascular disease.] ''Adv Cardiol'' 40 ():49-70. PMID: [http://pubmed.gov/14533546 14533546]</ref>
 
'''Supportive trial data:'''
*The incidence of [[pericardial effusion]] in patients with asymptomatic AIDS was 11% per year before the introduction of effective [[highly active antiretroviral therapy]] (HAART). The 6 month survival rate of AIDS patients with effusion was significantly shorter (36%) than the survival rate without effusions (93%). This shortened survival rate remained statistically significant after adjustment for lead-time bias and was independent of [[CD4 count]] and albumin level<ref name="pmid7586308">{{cite journal| author=Heidenreich PA, Eisenberg MJ, Kee LL, Somelofski CA, Hollander H, Schiller NB et al.| title=Pericardial effusion in AIDS. Incidence and survival. | journal=Circulation | year= 1995 | volume= 92 | issue= 11 | pages= 3229-34 | pmid=7586308 | doi= | pmc= | url= }} </ref>.
 
==References==
{{reflist|2}}
 
[[Category:Cardiology]]
[[Category:Diseases involving the fasciae]]
[[Category:Inflammations]]
[[Category:Emergency medicine]]
[[Category:Infectious disease]]


{{WH}}
[[Category: (name of the system)]]
{{WS}}

Latest revision as of 21:53, 5 December 2019

HIV induced pericarditis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating HIV induced pericarditis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | Echocardiography and Ultrasound | CT-Scan Findings | MRI Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Interventions | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1