Kaul S, Fishbein M C, Siegel R J
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048-0750.
Am Heart J. 1991 Aug;122(2):535-44. doi: 10.1016/0002-8703(91)91013-d.
Cardiac involvement is being identified more often clinically and at autopsy in patients with AIDS. Recent estimates suggest that in the United States as many as 5000 patients per year may have cardiac complications resulting from HIV infection. Patients with AIDS may have pericardial, myocardial, and/or endocardial disease. Pericardial tamponade and/or constriction may be related to neoplasms, infections, or nonspecific effusions. Myocardial dysfunction may result from specific neoplastic infiltration or myocarditis. Particularly intriguing is the role of HIV-1 in the nonspecific myocarditis and dilated cardiomyopathy that occurs in patients with AIDS. As in other debilitating conditions patients with AIDS can have nonbacterial thrombotic endocarditis. Infective endocarditis may be a complication, especially in AIDS associated with intravenous drug abuse. Most patients with AIDS have no overt clinical evidence of cardiac disease. When cardiac dysfunction does develop, the signs and symptoms are often misinterpreted to be the result of noncardiac causes (pulmonary failure or infection) which can mimic heart failure. This review is intended to alert the reader to the cardiac manifestations of AIDS, which present a number of diagnostic and therapeutic challenges.
在艾滋病患者中，临床上和尸检时发现心脏受累的情况越来越多。最近的估计表明，在美国每年多达5000名患者可能出现由HIV感染导致的心脏并发症。艾滋病患者可能患有心包、心肌和/或心内膜疾病。心包填塞和/或缩窄可能与肿瘤、感染或非特异性积液有关。心肌功能障碍可能由特定的肿瘤浸润或心肌炎引起。特别引人关注的是HIV-1在艾滋病患者发生的非特异性心肌炎和扩张型心肌病中所起的作用。与其他衰弱性疾病一样，艾滋病患者可发生非细菌性血栓性心内膜炎。感染性心内膜炎可能是一种并发症，尤其是在与静脉药物滥用相关的艾滋病患者中。大多数艾滋病患者没有明显的心脏病临床证据。当心脏功能障碍确实发生时，其体征和症状常常被误解为非心脏原因（肺衰竭或感染）所致，而这些原因可能会酷似心力衰竭。本综述旨在提醒读者注意艾滋病的心脏表现，这些表现带来了许多诊断和治疗方面的挑战。
