Cardiovascular abnormalities in the acquired immune deficiency syndrome - abstract

ABSTRACT

Serious organ system failure has been documented in the pulmonary, gastrointestinal, renal and central nervous systems in patients with cquired immune deficiency syndrome (AIDS). Clinical cardiac involvement has received little attention world-wide until the last few years, and in particular there has been no documentation or assessment of the cardiac involvement in patients with AIDS either in Barbados or the Caribbean. This study aims to assess the clinical cardiovascular findings in AIDS patients. A retrospective review and analysis of the case notes of AIDS patients who had died at the Queen Elizabeth Hospital, Barbados, in 1990 was undertaken. Prospective clinical assessment, including electrocardiography and echocardiography, was performed on a further set of patients admitted to hospital with HIV-related illness. The case notes of 31 (91 per cent) of the 34 patients with AIDS who died durng 1990 were reviewed. These patients were admitted to hospital on 77 occasions for AIDS-related illness. All patients were stage 3 or 4 according to the revised CDC/WHO classification. A clinical suspicion of cardiac involvement was entertained in 7 patients, 4 of whom were subsequently diagnosed as having a pericardial effusion - 2 of which were determined to be related to the presence of severe renal failure. Electrocardiography was performed on 7 patients; S-T segment elevation was noted in 2 of these patients. T-wave inversion in 1 patient and the effects of hyperkalaemia in 1 patient. Cardiac manifestations demonstrated in the AIDS patients studied prospectively will be presented. Cardiac involvement among AIDS patients admitted to hospital in Barbados is not clinically overt. A truer and higher incidence of cardiac manifestations in these patients will become evident by more detailed and systematic assessment (AU)