Article Text

PO-0231 Cardiac Involvement, Major Problem In Human Immunodeficiency Virus Infection In Children
  1. L Dimitriu1,
  2. C Jitareanu2,
  3. AG Dimitriu3
  1. 1Pediatric Cardiology, Medex Medical Center, Iasi, Romania
  2. 2Pediatric Cardiology, Children’s Hospital, Iasi, Romania
  3. 3Pediatric Cardiology, University of Medicine and Pharmacy, Iasi, Romania

Abstract

Objectives The present the main clinical aspects and diagnostic of cardiac involvement induced by human immunodeficiency virus infection in children.

Methods Patients: 51 children (2–16 years) with HIV infection/AIDS in various stages of evolution, with diverse symptoms affecting many organs. Evaluation of patients:clinical, ECG, Chest X ray, echocardiography (echo).

Results 60% of patients were included in group P2f clinical staging by clinical exam and CD4 lymphocytes values. Signs of cardiac involvement: heart failure (11 cases), tachycardia (20 cases), deafness of the heart sounds ± gallop rhythm ± systolic murmur of mitral regurgitation (12), dyspneea (14 cases), other non-symptomatic (14) or with signs of others diseases. ECG : disturbances of ventricular repolarisation. Rx. CT: cardiomegaly (30% cases) ± aspects of pulmonary infections. Echo exam: cardiac involvement (66% cases): dilated cardiomyopathy, the most severe changes (14 cases), pericarditis (10), isolated dilation of the left and right ventricle (6), LV diastolic dysfunctional (14 cases), pulmonary hypertension (6). The severity and incidence of cardiac disease was associated with significant reduction of CD4 value < 400/mmc. Hystological exam (28 patients died by pulmonary infections): myocarditis, pericardial and myocardial inflammatory infiltration, necrotic lesions.

Conclusion By the high incidence (66% of cases) and severity of clinical manifestations, cardiac suffering during HIV infection/AIDS is one of the most important problems of these patients. Cardiological evaluation of patients is necessary in all the stages of the infection, even non-symptomatic, for the diagnosis and follow-up of evolution. Echocardiography is the most sensitive noninvasive method for highlighting cardiac damage in these patients.

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