AIDS-related heart disease: a review of the literature

Heart disease related to the acquired immunodeficiency syndrome (AIDS) encompasses a number of pathologic findings that may or may not be associated with specific cardiac signs and symptoms. A review of 30 reports revealed that cardiac disorders were apparent in 424 (74%) of 574 AIDS patients. Neoplasms and opportunistic infections each were reported in 46 (8%) patients. The area of the heart most commonly affected was the myocardium. Pericardial disease as a single disorder was apparent in 14 patients, the etiologic bases of which were Mycobacterium tuberculosis. Cryptococcus neoformans infection, and unspecified fibrinous pericarditis. Endocardial disease was histologically evident in 18 patients with nonbacterial thrombotic endocarditis, and one patient was found to have Nocardia asteroides endocarditis. Although cardiac symptoms (dyspnea and chest pains); signs (pulsus paradoxus and murmurs); or ECG, roentgenogram, or echocardiographic manifestations of AIDS may be significant, they are not generally helpful in establishing a clinical diagnosis. Echocardiograms and a heightened degree of clinical suspicion have proven useful in detecting cardiac dysfunction and life-threatening cardiac tamponade.