HIV-associated myocarditis treated with zidovudine (AZT)

Congestive cardiomyopathy has been reported in patients infected with human immunodeficiency virus (HIV). In this report of diffuse lymphocytic myocarditis in a patient who tested positive for HIV antibody after receiving blood from an HIV-positive donor, the patient failed to respond to conventional medical therapy. Although no opportunistic infection or malignancy was observed by electron-and light-microscopic examination of the endomyocardial tissue sample at biopsy, it was decided to give the patient zidovudine (AZT) at a dosage of 200 mg every 4 hours. Definite clinical improvement was noted on repeat right heart catheterization and endomyocardial biopsy 3 months after the initiation of AZT therapy. This case supports the theory that myocarditis can be caused by HIV and suggests that AZT may be useful in the treatment of patients with HIV-associated cardiomyopathy.