Cardiovascular Advisor

What are HIV and AIDS?

HIV is the abbreviation used for the human immunodeficiency virus. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome), a life-threatening disease. The virus attacks the body's immune system. The immune system is the body's defense against infections.

HIV infection becomes AIDS when you lose your ability to fight off serious infections or tumors. AIDS can affect the heart in several ways.

What heart problems are related to AIDS?

Some problems with the heart that might be caused by AIDS are:

• myocarditis
• dilated cardiomyopathy
• pericarditis
• endocarditis
• cancer.

Myocarditis 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 make it harder for 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 does not pump enough blood.

Pericarditis is inflammation of the sac around the heart. This sac is called the pericardium. An infection may cause inflammation and fluid buildup. Sometimes there is so much fluid in the sac that there is not room for the heart to pump well. The fluid in the sac may need to be removed.

Endocarditis is an infection of layer of tissue that lines the inside of the heart muscle and valves. It can cause inflammation of the lining and severely damage the heart valves.

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

How are heart problems diagnosed?

Your healthcare provider will examine you. Often imaging testing is done as well. An echocardiogram is the best test. An echocardiogram makes pictures by bouncing sound waves off your heart. The pictures can 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 are heart problems related to AIDS 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. In most cases cardiomyopathy is treated with medicines. Little can be done to treat cancers that involve the heart.