HIV Retro virus : Changed priorities towards the human heart : Harrison 17th & 18th Editions

HIV Retro virus : Changed priorities towards the human heart : Harrison 17th & 18th Editions

You are now reading one post among a series of posts which give you must know points from Harrison which are often asked in AIIMS, PGI and AIPG Exams. These are based on the teaching material of OHC 2 : Operation Harri 2, a Crash Course for AIIMS, PGI and AIPG, being conducted by Positive

Dear Doctors
Greetings from POSITIVE

A new entrance exam oriented point from HARRISON-18TH EDITION : Retro virus- changed priorities towards the human heart!!!.

17th EDITION

• *Heart disease is a relatively common postmortem finding in HIV-infected patients (25–75% in autopsy series).
• *As a primary consequence of HIV infection, the most common clinically significant finding is a dilated cardiomyopathy associated with congestive heart failure (CHF), referred to as HIV-associated cardiomyopathy.
• *This generally occurs as a late complication of HIV infection and, histologically, displays elements of myocarditis.
• *A variety of other cardiovascular problems are found in patients with HIV infection. Pericardial effusions may be seen in the setting of advanced HIV infection.
• * Nonbacterial thrombotic endocarditis has been reported and should be considered in patients with unexplained embolic phenomena. Intravenous pentamidine, when given rapidly, can result in hypotension as a consequence of cardiovascular collapse.
• *In one large series the overall rate of myocardial infarction (MI) was 3.5/1000 years, 28% of these events were fatal, and MI was responsible for 7% of all deaths in the cohort. The risk of MI increased by 26% per year of HAART.

18TH EDITION

• *Heart disease is a relatively common postmortem finding in HIV-infected patients (25–75% in autopsy series).
• *The most common form of heart disease is coronary heart disease.
• * In one large series the overall rate of myocardial infarction (MI) was 3.5/1000 patient-years, 28% of these events were fatal, and MI was responsible for 7% of all deaths in the cohort.
• * Another form of heart disease associated with HIV infection is a dilated cardiomyopathy associated with congestive heart failure (CHF) referred to as HIV-associated cardiomyopathy. This generally occurs as a late complication of HIV infection and, histologically, displays elements of myocarditis. For this reason some have advocated treatment with IV immunoglobulin (IVIg).
• * A variety of other cardiovascular problems are found in patients with HIV infection. Pericardial effusions may be seen in the setting of advanced HIV infection. Predisposing factors include TB, CHF, mycobacterial infection, cryptococcal infection, pulmonary infection, lymphoma, and KS. While pericarditis is quite rare, in one series 5% of patients with HIV disease had pericardial effusions that were considered to be moderate or severe.
• *Nonbacterial thrombotic endocarditis has been reported and should be considered in patients with unexplained embolic phenomena. Intravenous pentamidine, when given rapidly, can result in hypotension as a consequence of cardiovascular collapse.

You are now reading one post among a series of posts which give you must know points from Harrison which are often asked in AIIMS, PGI and AIPG Exams. These are based on the teaching material of OHC 2 : Operation Harri 2, a Crash Course for AIIMS, PGI and AIPG, being conducted by Positive

What is in store for tomorrow?
How sleep pattern has changed in the 18th edition-kindly log on tomorrow?????