Letts Dustin P, López-Candales Angel
Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Echocardiography. 2004 Nov;21(8):715-9. doi: 10.1111/j.0742-2822.2004.03121.x.
Cardiovascular manifestations in patients infected with human immunodeficiency virus (HIV) have been altered by the introduction of highly active antiretroviral therapy regimens that allow more effective prophylactic treatment and an increased time of survival. Because of this, noninfectious cardiac conditions associated with HIV disease are being recognized with increasing frequency in these patients. Cardiac involvement in HIV-infected patients varies from clinically silent to overtly symptomatic disease. By some estimates a direct cardiac cause of mortality is between 1% and 6% of all cases. Pericardial effusion, pericarditis, myocarditis, cardiomyopathy, endocarditis, and pulmonary hypertension are well-recognized cardiac illnesses associated with HIV infection. Echocardiography has been crucial in evaluating HIV-infected patients to assess the extent of cardiac involvement. This case report illustrates atypical echocardiographic manifestations of endocarditis and paravalvular abscess in an immunocompromised patient.
随着高效抗逆转录病毒治疗方案的引入,感染人类免疫缺陷病毒(HIV)患者的心血管表现已发生改变,该方案可实现更有效的预防性治疗并延长生存期。正因如此,这些患者中与HIV疾病相关的非感染性心脏疾病的确诊频率越来越高。HIV感染患者的心脏受累情况从临床无症状到明显有症状不等。据一些估计,在所有病例中,直接由心脏原因导致的死亡率在1%至6%之间。心包积液、心包炎、心肌炎、心肌病、心内膜炎和肺动脉高压是与HIV感染相关的公认心脏疾病。超声心动图在评估HIV感染患者以确定心脏受累程度方面至关重要。本病例报告展示了一名免疫功能低下患者心内膜炎和瓣周脓肿的非典型超声心动图表现。