Cardiac disease has been reported in patients with AIDS based on clinical, echocardiographic and autopsy findings. While abnormalities are often clinically silent, patients have developed congestive heart failure, cardiomyopathy, pericardial effusions and cardiac tamponade. Cardiac abnormalities may be caused by primary HIV infection of the myocardium, by superinfections or by the sequelae of drug therapy, substance abuse, renal impairment, or pulmonary disease. HIV-related cardiomyopathy is characterized by left ventricular dilatation and hypocontractility, which may result in heart failure and pulmonary congestion.
Patient complains of difficulty breathing, swelling, or chest pain at mid-sternum.
Frequently patients are asymptomatic. Order good quality PA and lateral CXRs. Changes will be non-specific. Afterload reduction with ACE inhibitor. Bed rest, TED hose for edema.