Cardiological Emergencies in HIV-Infected Patients

Abstract

Many cardiac complications in acquired immunodeficiency syndrome (AIDS) that may be faced by emergency department (ED) physicians are due to opportunistic infections or malignancy, but they may also be associated with other aspects of human immunodeficiency virus (HIV) disease and its treatment (Table 1) [1]. The clinical expression of cardiac involvement is variable and is affected by the stage of HIV dis- HIV-associated cardiac disease Cardiac emergencies C. Fungal/yeast (Candida albicans, Aspergillus fumigatus, Cryptococcus neoformans) Nonbacterial thrombotic endocarditis Systematic embolization (lung, brain, kidney, spleen disseminated intravascular coagulopathy) Pericardial Pericardial effusion/pericarditis Cardiac tamponade, arrhythmias, CHF (for chronic pericardial effusions) A. Infectious 1. Bacterial (Mycobacterium tuberculosis, M. avium intracellulare, Nocardia asteroides) 2. Viral (Coxsackievirus, Epstein-Barr virus, cytomegalovirus, adenovirus, herpes virus) 3. Fungal (Histoplasma capsulatum, Cryptococcus neoformans) B. Idiopathic (HIV, autoimmune) C. Uremic D. Neoplastic (Kaposi’s sarcoma, non-Hodgkin’s lymphoma) sease, the degree of immunodeficiency, and the drugs used to treat HIV disease-i.e., zidovudine and protease inhibitors (PIs) in the era of highly active antiretroviral therapy (HAART) regimens-or to treat or prevent opportunistic infections and neoplasms (e.g., pentamidine, cotrimoxazole, interferon α) [2].