Our increased understanding of the human immunodeficiency virus (HIV), including elucidation of the processes of transmission and replication, has led to the development of relatively effective therapies to minimise and manage the clinical consequences of HIV infection. These therapeutic developments have undoubtedly improved rates of morbidity and mortality in infected patients. The improvements in quality of life and life expectancy have been accompanied by an increase in the number of patients demonstrating cardiac complications, occurring either as a result of the infection itself or the drugs used to control the virus.
Cardiac involvement occurs frequently in HIV/AIDS patients and it seems likely that the myocardium, pericardium and/or endocardium are involved. Myocarditis, one of the most common types of cardiac involvement observed in HIV patients, the cause of which can be difficult to identify, may be responsible for myocardial dysfunction. Opportunistic infections, including HIV itself, have been suggested as the cause of myocarditis. Dilated cardiomyopathy is usually found in the late stage of HIV infection and myocarditis may be the triggering causative factor. The mechanism behind pericardial effusion remains unclear but it too may be related to infections or neoplasms. Non-bacterial thrombotic endocarditis and infective endocarditis have been described in AIDS patients, both of which cause significant morbidity. Human immunodeficiency virus-related pulmonary hypertension is a diagnosis of exclusion, and symptoms and signs may mimic other pulmonary conditions in AIDS patients. Cardiac Kaposi’s sarcoma and cardiac lymphoma are the frequently encountered malignant neoplasms in AIDS patients – the prognosis is grave in patients with these conditions.
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