Herdy G V, Ramos R, Bazin A R, Herdy A H, Almeida P S, Ramos R G, Carrinho M
Hospital Antônio Pedro, UFF, Niterói, RJ.
Arq Bras Cardiol. 1994 Feb;62(2):95-8.
To analyze myocardial abnormalities in patients of acquired immunodeficiency syndrome with clinical and pathological correlation.
We selected 50 cases, retrospectively, age ranged from 3 months to 40 years, all of them had myocardial changes and the data of clinical records fulfilled our protocol. Cases of others cardiac diseases were not included.
The pathological findings were: myocarditis in 33 (11 had severe myocarditis) and degenerative hystological lesions in 17. The etiologic agents detected were: Toxoplasma in 11, Cryptococcus in 7 and Cytomegalovirus in 3. In 12 cases we could not find any agent. In 15 cases occurred others lesions: endocarditis, pericarditis and sarcoma of Kaposi. It was noted tachycardia in 15 cases, decrease of heart sounds in 12, arterial hypotension in seven, systolic murmur in 8, galop rhythm in 7, pericardial friction rub in 3, arrhythmia in 2. Four patients had congestive heart failure. The EKG showed sinus tachycardia in 18, ST and T changes in 10, low voltage in 5, ST segment elevation in 5 and extrasystoles in 3 cases. The echocardiogram findings were: pericardial effusion in 9 cases and 9 had ventricular dysfunction.
The cardiac lesions were very important even in patients without clinical signals. We need others prospective studies with viral identification trying to detect specific lesions of HIV.
分析获得性免疫缺陷综合征患者的心肌异常情况，并进行临床与病理相关性分析。
我们回顾性选取了50例患者，年龄从3个月至40岁，所有患者均有心肌改变，且临床记录数据符合我们的方案。未纳入其他心脏病病例。
病理检查结果为：33例为心肌炎（其中11例为重症心肌炎），17例为退行性组织学病变。检测到的病原体为：11例为弓形虫，7例为隐球菌，3例为巨细胞病毒。12例未发现任何病原体。15例出现其他病变：心内膜炎、心包炎和卡波西肉瘤。15例出现心动过速，12例心音减弱，7例动脉低血压，8例收缩期杂音，7例奔马律，3例心包摩擦音，2例心律失常。4例患者出现充血性心力衰竭。心电图显示18例窦性心动过速，10例ST段和T波改变，5例低电压，5例ST段抬高，3例早搏。超声心动图检查结果为：9例心包积液，9例心室功能障碍。
即使在无临床症状的患者中，心脏病变也很重要。我们需要进行其他前瞻性研究，通过病毒鉴定来检测HIV的特异性病变。
