Echocardiography on HIV patients admitted to the ICU

Abstract

A prospective echocardiographic study was conducted in 68 patients with the human immunodeficiency virus (HIV) admitted to the intensive care unit (ICU) (C3 stage 78%, i.v. drug abuse 71%) in order, firstly to, assess the prevalence of cardiac abnormalities, and, secondly, to make an early therapeutic decision. Only five patients presented clinical evidence of cardiac disease. Echocardiographic abnormalities were identified in 35 patients (51%): pericardial effusion: 20 cases (29%), with tamponade in 2 cases that led to an immediate pericardiocentesis. Left ventricular dysfunction: 15 cases (22%) requiring treatment of cardiac failure. Mitral bioprosthesis rupture in 1 patient that led to a surgical procedure. Vegetations of the tricuspid value in 3 drug addicts (4%) requiring early antibiotic treatment. Echocardiography proved to be very helpful in detecting hidden cardiac dysfunctions. It is immensely valuable in ICU management of HIV patients, since prompt initiation of appropriate treatment is essential.

Echocardiographic Findings and Their Impact on Outcomes of Critically Ill Patients with AIDS in the Era of HAART

“…Echocardiographic abnormalities among hospitalized HIV population are reported to be around 50% in two different studies [13, 14]. The prevalence of abnormal echocardiogram in our AIDS population was slightly higher than previously reported for HIV population admitted to the ICU by Blanc et al [13]. In the study by Blanc et al, pericardial effusion was the most common (29%) abnormality followed by LV dysfunction (22%).…”

“…Since then, a number of studies have estimated the prevalence of cardiac involvement in AIDS patients to range from 28% to 73% [9, 11–13]. Echocardiographic abnormalities among hospitalized HIV population are reported to be around 50% in two different studies [13, 14]. The prevalence of abnormal echocardiogram in our AIDS population was slightly higher than previously reported for HIV population admitted to the ICU by Blanc et al [13].…”

“…Pericardial effusion has also been shown to predict increased mortality among HIV infected patients [11, 12]. Blanc et al performed a prospective echocardiographic study in HIV-patients admitted to the intensive care unit (ICU) preceding the highly active antiretroviral therapy (HAART) era and found a similar prevalence of cardiac abnormalities as previously published studies [13]. Hakim et al presented an abstract of echocardiographic findings in hospitalized HIV patients which showed that 50% of the patients have echocardiographic abnormalities [14].…”

“…Echocardiography these days is done on almost every patient admitted to the intensive care units. The information obtained from the echocardiogram does guide treatment in majority of these patients and HIV patients are not different [13]. The first cardiac manifestation of AIDS was described in 1983 by Autran et al, when they published a case of cardiac Kaposi' sarcoma in a Haitian woman [17].…”

“…The first cardiac manifestation of AIDS was described in 1983 by Autran et al, when they published a case of cardiac Kaposi' sarcoma in a Haitian woman [17]. Since then, a number of studies have estimated the prevalence of cardiac involvement in AIDS patients to range from 28% to 73% [9, 11–13]. Echocardiographic abnormalities among hospitalized HIV population are reported to be around 50% in two different studies [13, 14].…”