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[Pathology of the heart in AIDS. Study of 73 consecutive necropsies]
M Politi Okoshi1, M Rubens Montenegro
1Faculdade de Medicina de Botucatu-UNESP.
Insights
Autopsy studies reveal frequent cardiac lesions in patients with acquired immunodeficiency syndrome (AIDS). Myocardial involvement was common, with various pathogens identified in a significant number of cases.
Area of Science:
- Cardiovascular Pathology
- Infectious Diseases
- Immunology
Context:
- Acquired immunodeficiency syndrome (AIDS) is a complex condition with multi-organ involvement.
- Cardiac complications are increasingly recognized in AIDS patients.
- Understanding cardiac pathology in AIDS is crucial for comprehensive patient care.
Purpose:
- To investigate the incidence and etiological factors of cardiac lesions in individuals with AIDS.
- To document the spectrum of heart abnormalities observed during post-mortem examinations of AIDS patients.
Summary:
- Autopsy review of 73 AIDS patients showed heart involvement in 90% of cases.
- Common findings included cardiac atrophy, lipomatosis, and interstitial myocardial infiltrates.
- Infectious agents such as Cryptococcus neoformans, Mycobacterium tuberculosis, and Cytomegalovirus were identified in 13 cases.
Impact:
- Highlights the high prevalence of cardiac pathology in AIDS.
- Identifies specific pathogens contributing to cardiac lesions.
- Emphasizes the importance of autopsy in understanding AIDS-related organ damage.
Purpose:
To study the incidence and the etiology of the cardiac lesions in AIDS patients.
Methods:
The autopsy protocols and the filled slides of the heart from 73 consecutive AIDS patients were reviewed. There were, at least, 2 slides of each heart stained by haematoxylin-eosin; when indicated, Ziehl-Nielsen, Gram and Gomori Grocott stains were used.
Results:
No cause of death was assigned to the heart. There was involvement of the heart in 66 (90%) cases. Marked atrophy of cardiac fibers with or without lipomatosis was observed in 38 patients. Interstitial infiltrates of myocardium were present in 38 necropsies and in 13 of these cases a probable pathogen was demonstrated: cryptococcus neoforms in three cases and mycobacteria tuberculosis, atypical mycobacteria, toxoplasma' gondii, trypanosoma cruzi and cytomegalovirus in two cases each. Bacterial endocarditis was found in 4 autopsies and Kaposi sarcome in one. The pericardium was involved in 22 cases; in 12 there was only non specific mononuclear infiltration.
Conclusion:
Autopsy examination of the heart from AIDS patients revealed frequent pathologic involvement.