A Study of Cardiovascular Abnormalities in HIV Positive Patients in a Tertiary Care Hospital in Northern India.

Introduction: Cardiovascular illness is common in patients with HIV infection, particularly in the later course of disease. Cardiovascular abnormalities in people living with HIV disease (PLHIV) often go unrecognized or untreated resulting in increased cardiovascular related morbidity and mortality and reduced quality of life. The prevalence of cardiac involvement in PLHIV has been reported to range between 28 to 73%. However, the incidence of symptomatic heart failure in HIV positive patients is 8-10%. Aims and Objectives: The present study had been undertaken to study the prevalence of cardiovascular manifestation in HIV positive patients in north Indian population and its association with HAART, CD4 count and WHO stages of the disease. Material and Methods: This study was conducted in the department of Medicine, KGMU, Lucknow. A total of 75 HIV positive patients of age >15 years, admitted to the hospital were enrolled, out of which 32 were on ART. The cardiovascular evaluation in the form of chest x-ray, ECG, 2D echocardiography and NT-ProBNP was done and their correlations with CD4 count was studied. Two rheumatic heart disease patients were excluded during analysis. Results: Cardiovascular manifestations were found in around 52.1% of HIV positive patients. Chest x-ray showed cardiomegaly in 8 out of 73 patients. ECG abnormalities were found in 49.3% while 2 D echocardiography was abnormal in 52.1% of the patients. Though NT-Pro BNP was abnormal in 26.7% of the patients, no statistical correlation was found with CD4 counts. Conclusion: The prevalence of cardiovascular abnormalities in our study population was 52.1%. Our study did not show any statistical correlation with CD4 counts but showed correlation with the WHO clinical staging of the disease. We suggest a study with larger sample size to see the exact prevalence of cardiovascular disease in HIV positive patients.

Ebstein's anomaly with recurrent massive pericardial effusion: a rare presentation.

Ebstein's anomaly is known for its varied presentations and exceptionally long survival in some cases. Here the authors describe a case of previously undiagnosed Ebstein's anomaly in a patient who presented with massive pericardial effusion. Over the next 6 months, the patient was hospitalised twice for pericardiocentesis. To the best of our knowledge, a case of Ebstein's anomaly with recurrent massive pericardial effusion has not been described previously.