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

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