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1994-10-01
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Document 0031
DOCN M94A0031
TI [Heart and AIDS]
DT 9412
AU Buhler JA; Schneider J; Departement Pathologie, Universitat Zurich.
SO Schweiz Med Wochenschr. 1994 Jul 30;124(30):1326-33. Unique Identifier :
AIDSLINE MED/94353179
AB Although pulmonary and central nervous symptoms prevail before death,
autopsy often reveals marked myocardial alterations in AIDS patients.
This discrepancy prompted us to systematically study cardiac alterations
in 100 sequential autopsies of patients who died of AIDS. We appraised
the results in relation to changes noted in other organ systems, and
compared our data with the AIDS-associated cardiac alterations described
in the literature. Cardiac lesions were present in more than 50% of our
patients, predominantly in the myocardium (47%). 38 patients displayed
signs of active myocarditis. The endocardium and epicardium were
secondarily involved, although drug abuse (23 patients) was the most
important risk factor for HIV infection, after homosexuality (44%). The
prevailing opportunistic agents were identical to those generally seen
in AIDS patients, i.e. toxoplasma, cytomegalovirus, mycobacteria and
fungi, with the exception of Pneumocystis carinii. This microorganism
spared the heart, although it was present in the lungs of 47 patients.
Our results are in keeping with other published data. Toxoplasma,
present in the myocardium of our patients more frequently than reported
in other series, did not necessarily cause a concomitant myocarditis;
Coxsackie viruses are deemed to be responsible for many cases of
myocarditis in AIDS patients, perhaps even in cases in which we found
toxoplasma pseudocysts to be present in the heart muscle. The study
clearly shows that the heart is often the unrecognized target of
AIDS-associated lesions, even in the initial phase of the AIDS outbreak
(1981-1989). Thus, not every shortness of breath is necessarily of
pulmonary origin.(ABSTRACT TRUNCATED AT 250 WORDS)
DE Acquired Immunodeficiency Syndrome/*PATHOLOGY Adult Aged AIDS-Related
Opportunistic Infections/PATHOLOGY Endocarditis/PATHOLOGY English
Abstract Female Human Male Middle Age
Myocarditis/MICROBIOLOGY/*PATHOLOGY/PARASITOLOGY Myocardium/*PATHOLOGY
Pericardium/PATHOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).