Symptomatic cardiac dysfunction in children with human immunodeficiency virus infection

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Cardiovascular Pathology

Background:

• Symptomatic cardiac dysfunction is a concern in children with human immunodeficiency virus (HIV) infection.
• Clinical signs of heart failure can be masked by concurrent infections, anemia, and hepatosplenomegaly.

Purpose of the Study:

• To investigate the presentation, diagnosis, and management of cardiac dysfunction in pediatric HIV patients.
• To evaluate the utility of echocardiography in diagnosing cardiac compromise in this population.

Main Methods:

• Retrospective analysis of eight children with HIV and symptomatic cardiac dysfunction.
• Clinical examination, electrocardiography (ECG), echocardiography, and autopsy findings were reviewed.
• Assessment of response to medical therapy.

Main Results:

• All eight patients exhibited decreased left ventricular function; six had dilated left ventricular myopathy.
• ECG showed abnormalities in seven of eight, but chest X-rays were not diagnostic.
• An S3 gallop was a key indicator of cardiac dysfunction.
• Medical therapy improved cardiac function in all patients, but all died from non-cardiac causes.

Conclusions:

• Cardiac dysfunction in pediatric HIV can be obscured by other clinical findings.
• Echocardiography is crucial for diagnosing cardiac compromise in these patients.
• While medical therapy can improve cardiac function, non-cardiac complications remain the primary cause of mortality.