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Chronic Total Occlusion of the Left Main Coronary Artery in an HIV-Infected Patient

Rajeev Seecheran1, Tiffany Kawall1, Valmiki Seecheran1

  • 1Department of Medicine, North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago.

International Medical Case Reports Journal
|November 19, 2020
PubMed

Insights

Coronary artery disease (CAD) is a leading cause of death in HIV patients. This case study details a rare instance of left main coronary artery chronic total occlusion (LMCA CTO) in an HIV-infected individual presenting with heart failure and ventricular tachycardia.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Coronary artery disease (CAD) is a significant cause of mortality in individuals with human immunodeficiency virus (HIV).
  • Left main disease (LMD) affects approximately 5% of HIV-infected patients, with chronic total occlusion (CTO) being exceptionally rare.
  • Management of cardiovascular complications in HIV requires specialized attention due to unique risk factors.

Observation:

  • A case of a non-adherent HIV-infected patient is presented.
  • The patient exhibited a chronic total occlusion (CTO) of the left main coronary artery (LMCA).
  • Clinical presentation included heart failure with mildly reduced ejection fraction (HFrEF) and ventricular tachycardia (VT).

Findings:

  • This report highlights an extremely rare occurrence of LMCA CTO in an HIV-positive individual.
  • The patient's presentation of HFrEF and VT underscores the potential severity of untreated coronary artery disease in this population.
  • Non-adherence to medical treatment may exacerbate cardiovascular risks in HIV patients.

Implications:

  • This case emphasizes the importance of comprehensive cardiovascular risk assessment and management in HIV-infected individuals.
  • Early detection and treatment of CAD, including rare presentations like LMCA CTO, are crucial for improving outcomes.
  • Further research into the specific mechanisms and optimal treatment strategies for CAD in HIV is warranted.

Keywords:
CTOHIVLMCALMDchronic total occlusionhuman immunodeficiency virusleft main coronary arteryleft main disease

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