Cardiac diseases in AIDS natural history, complications and prognosis: Difference between revisions
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{{Cardiac diseases in AIDS}} | {{Cardiac diseases in AIDS}} | ||
{{CMG}}; {{AE}} {{RT}} | {{CMG}}; {{AE}} {{RT}} | ||
==Overview== | |||
Presence of cardiac conditions like [[pericarditis]] (even if asymptomatic), [[cardiomyopathy]] and [[pulmonary hypertension]] in HIV infected patients carries poor prognosis. | |||
==Natural History== | |||
The majority of pericardial effusions (80%) in the setting of AIDS are small and asymptomatic. Studies have reported that these effusions resolve spontaneously in 42% of the patients <ref name="pmid7586308">{{cite journal |author=Heidenreich PA, Eisenberg MJ, Kee LL, ''et al.'' |title=Pericardial effusion in AIDS. Incidence and survival |journal=[[Circulation]] |volume=92 |issue=11 |pages=3229–34 |year=1995 |month=December |pmid=7586308 |doi= |url=}}</ref>. | |||
==Complications== | ==Complications== | ||
Complications from involvement of heart in AIDS include: | Complications from involvement of heart in AIDS include: | ||
* [[Cardiac tamponade]] from severe [[pericardial effusion]]s | * [[Cardiac tamponade]] from severe [[pericardial effusion]]s <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> | ||
* [[Heart failure]] from [[dilated cardiomyopathy]] ([[DCM]]) | * [[Heart failure]] from [[dilated cardiomyopathy]] ([[DCM]]) | ||
* | * [[Disseminated intravascular coagulation]] ([[DIC]]), systemic embolization and [[stroke]] from [[infective endocarditis]] | ||
* Valvular regurgitations | * Valvular regurgitations | ||
* [[Heart block]]s | * [[Heart block]]s | ||
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==Prognosis== | ==Prognosis== | ||
[[Pericarditis]] in AIDS | Prognosis is very poor in: | ||
* [[Pericarditis]]: Mortality is significantly higher with shortened survival in patients with effusions even if they resolve spontaneously over time <ref name="pmid7586308">{{cite journal |author=Heidenreich PA, Eisenberg MJ, Kee LL, ''et al.'' |title=Pericardial effusion in AIDS. Incidence and survival |journal=[[Circulation]] |volume=92 |issue=11 |pages=3229–34 |year=1995 |month=December |pmid=7586308 |doi= |url=}}</ref><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><ref name="pmid7781340">{{cite journal |author=Flum DR, McGinn JT, Tyras DH |title=The role of the 'pericardial window' in AIDS |journal=[[Chest]] |volume=107 |issue=6 |pages=1522–5 |year=1995 |month=June |pmid=7781340 |doi= |url=}}</ref>. | |||
* [[Cardiomyopathy]]: Cardiomyopathy associated with HIV infection carries worst prognosis compared to other non-ischemic types of cardiomyopathy. Rapid onset CHF has a poorer prognosis than gradual onset CHF <ref name="pmid10760308">{{cite journal |author=Felker GM, Thompson RE, Hare JM, ''et al.'' |title=Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy |journal=[[The New England Journal of Medicine]] |volume=342 |issue=15 |pages=1077–84 |year=2000 |month=April |pmid=10760308 |doi=10.1056/NEJM200004133421502 |url=}}</ref>. | |||
* [[Pulmonary hypertension]]: Median survival is 6 months. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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{{WikiDoc Sources}} | |||
[[CME Category::Cardiology]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Disease]] | |||
Latest revision as of 17:19, 18 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Overview
Presence of cardiac conditions like pericarditis (even if asymptomatic), cardiomyopathy and pulmonary hypertension in HIV infected patients carries poor prognosis.
Natural History
The majority of pericardial effusions (80%) in the setting of AIDS are small and asymptomatic. Studies have reported that these effusions resolve spontaneously in 42% of the patients [1].
Complications
Complications from involvement of heart in AIDS include:
- Cardiac tamponade from severe pericardial effusions [2]
- Heart failure from dilated cardiomyopathy (DCM)
- Disseminated intravascular coagulation (DIC), systemic embolization and stroke from infective endocarditis
- Valvular regurgitations
- Heart blocks
- Superior vena caval syndrome due to cardiac tumors
- Death
Prognosis
Prognosis is very poor in:
- Pericarditis: Mortality is significantly higher with shortened survival in patients with effusions even if they resolve spontaneously over time [1][2][3].
- Cardiomyopathy: Cardiomyopathy associated with HIV infection carries worst prognosis compared to other non-ischemic types of cardiomyopathy. Rapid onset CHF has a poorer prognosis than gradual onset CHF [4].
- Pulmonary hypertension: Median survival is 6 months.
References
- ↑ 1.0 1.1 Heidenreich PA, Eisenberg MJ, Kee LL; et al. (1995). "Pericardial effusion in AIDS. Incidence and survival". Circulation. 92 (11): 3229–34. PMID 7586308. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 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) - ↑ Flum DR, McGinn JT, Tyras DH (1995). "The role of the 'pericardial window' in AIDS". Chest. 107 (6): 1522–5. PMID 7781340. Unknown parameter
|month=ignored (help) - ↑ Felker GM, Thompson RE, Hare JM; et al. (2000). "Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy". The New England Journal of Medicine. 342 (15): 1077–84. doi:10.1056/NEJM200004133421502. PMID 10760308. Unknown parameter
|month=ignored (help)