View source for Cardiac diseases in AIDS natural history, complications and prognosis

__NOTOC__
{{Cardiac diseases in AIDS}}
{{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 from involvement of heart in AIDS include:
* [[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]])
* [[Disseminated intravascular coagulation]] ([[DIC]]), systemic embolization and [[stroke]] from [[infective endocarditis]]
* Valvular regurgitations
* [[Heart block]]s
* [[Superior vena caval syndrome]] due to [[cardiac tumor]]s
* [[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 <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==
{{Reflist|2}}

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