Open Access

C21. Cardiac Complications in Immunocompromised Patient : A Case Report

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Date: 23 November 2021
Journal: European Heart Journal Supplements , Volume 23 , Issue Supplement_F
Authors: R. Hanafiah , V. Candra

ESC Journals

AbstractBackground

Cardiovascular diseases in human immunodeficiency virus (HIV)-positive patients are becoming increasingly detected in developing countries. Pericardial involvement may be manifested as acute pericarditis, constrictive pericarditis, symptomatic pericardial effusion and cardiac tamponade. The aim of this report is to present a patient with AIDS clinical stage IV who developed pericarditis and pericardial effusion.

Case Summary

A 27-year-old male came to our ER with 7-day fever and delirium syndrome. He has been diagnosed with AIDS clinical stage IV for the past 3 years with the latest CD4 count was 6/mm3. Serial Transthoracic Echocardiography (TTE) revealed small to moderate circumferential pericardial effusion, thickening of pericardium and reduced left ventricular ejection fraction without signs of cardiac tamponade from TTE. Upon hospitalization, he developed signs of hypotension without distended jugular veins nor muffled heart sounds. It was decided to initiate supportive treatment and NSAIDs without pericardiocentesis. The patient recovered uneventfully. As an outpatient, no other cardiovascular complications developed.

Discussion

Pericardial conditions are the most frequent cause of heart disease in patient with HIV infection. Most cases are mild and asymptomatic. Pericardial effusion may be marker of end-stage HIV infection because it is associated with low CD4 cell count and is often caused by opportunistic infections and malignant neoplasms. Treatment of pericarditis in HIV patients is no different from that in general population. Asymptomatic patients with small pericardial effusion without tamponade require no intervention.

About the contributors

R Hanafiah

Role: Author

V F K Candra

Role: Author