HIV Disease and the Heart

What is HIV disease?

HIV (Human Immunodeficiency Virus) disease is a disease in which a virus destroys part of the body's immune system. The immune system is the body's defense against infections.

If someone has the virus but can still fight off infection it is known as being "HIV-positive." When the disease is more advanced, the body cannot fight off serious infection. This is known as AIDS (Acquired Immuno-Deficiency Syndrome). AIDS can affect the heart in several ways.

What kinds of heart disease are related to AIDS?

MYOCARDITIS: This is an inflammation of the heart muscle. Several viruses common in people who have AIDS can cause myocarditis. The AIDS virus itself may cause myocarditis. Sometimes the cause of myocarditis is not known.

Myocarditis may cause severe heart rhythm problems or decrease the ability of the heart to pump. It can lead to dilated cardiomyopathy, which means that the heart gets big and the heart muscle thins and gets weak. As the heart muscle weakens, it doesn't pump enough blood.

PERICARDITIS: The pericardium is the sac that surrounds the heart. An infection may cause inflammation and fluid buildup in the sac. Sometimes there is so much fluid in the sac that there isn't room for the heart to pump well. The fluid in the sac may need to be removed.

ENDOCARDITIS: The endocardium is a layer of tissue that lines the inside of the heart muscle and valves. Endocarditis is an infection of this lining. It can cause inflammation of the lining and failure of infected heart valves.

ENDOCARDITIS: The endocardium is a layer of tissue that lines the inside of the heart muscle and valves. Endocarditis is an infection of this lining. It can cause inflammation of the lining and severely damage the heart valves.

CANCER: People with AIDS are more likely to develop certain types of cancer. Some of these cancers, like lymphoma, can start in the heart. Some, like Kaposi's sarcoma, can spread from other parts of the body. Sometimes the cancer does not cause a problem for the heart, but sometimes they can interfere with blood flow through the heart. Cancer can also cause a build-up of fluid around the heart.

How is it diagnosed?

A physical exam isn't usually enough to find heart problems. An echocardiogram is the best test. An echocardiogram makes pictures by bouncing sound waves off your heart. The pictures show:

• the size of the heart chambers and thickness of muscle walls
• the ability of the heart muscle to squeeze
• any fluid that may be in the pericardial sac.

How is it treated?

Treatment for heart disease is the same whether or not you have AIDS. Most of these conditions may be treated with medicines such as antibiotics or anti-inflammatory medicines. Cardiomyopathy may be treated with medicines or surgery. Little can be done to treat cancers that involve the heart.