Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- 18 Cutaneous diseases
- 19 Neurologic problems
- 20 Ophthalmic problems
- 21 Oral health and dental problems
- 22 Otitis media and sinusitis
- 23 Cardiac problems
- 24 Pulmonary problems
- 25 Hematologic problems
- 26 Gastrointestinal disorders
- 27 Renal disease
- 28 Endocrine disorders
- 29 Neoplastic disease in pediatric HIV infection
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendix 1 Formulary of antiretroviral agents
- Appendix 2 National Institutes of Health sponsored clinical trials for pediatric HIV disease
- Appendix 3 Selected HIV-related internet resources
- Appendix 4 Selected legal resources for HIV-infected children
- Index
- References
23 - Cardiac problems
Published online by Cambridge University Press: 23 December 2009
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- 18 Cutaneous diseases
- 19 Neurologic problems
- 20 Ophthalmic problems
- 21 Oral health and dental problems
- 22 Otitis media and sinusitis
- 23 Cardiac problems
- 24 Pulmonary problems
- 25 Hematologic problems
- 26 Gastrointestinal disorders
- 27 Renal disease
- 28 Endocrine disorders
- 29 Neoplastic disease in pediatric HIV infection
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendix 1 Formulary of antiretroviral agents
- Appendix 2 National Institutes of Health sponsored clinical trials for pediatric HIV disease
- Appendix 3 Selected HIV-related internet resources
- Appendix 4 Selected legal resources for HIV-infected children
- Index
- References
Summary
Introduction
As the survival of HIV-infected patients improves, the cardiovascular complications of HIV infection are becoming an increasingly common cause of morbidity and mortality. The prevalence of cardiovascular disease is estimated to be more than 90% in pediatric HIV patients [1–3]. The spectrum of cardiovascular disorders includes abnormalities in left ventricular performance, wall thickness, contractility, dilated cardiomyopathy, myocarditis, pericarditis, and rhythm disturbances. Cardiac complications have surpassed pulmonary disease as the leading cause of death in HIV-infected patients [4]. The recognition of cardiovascular complications can be very difficult because many patients are asymptomatic until late in the disease course. In addition, the cardiac symptoms can be inadvertently attributed to other causes such as pulmonary or infectious etiologies. Early detection of these symptoms is only possible if clinicians have a fundamental understanding of the wide array of cardiovascular complications associated with HIV infection. The initiation of routine screening and monitoring will allow clinicians the ability to intervene and hopefully prevent or delay the onset of these complications in the future.
Risk factors
Several risk factors for cardiovascular disease among HIV-infected children have been described. The triad of encephalopathy, wasting, and low CD4 counts in children with HIV have been shown to be associated with an increased the risk of cardiovascular complications and decreased survival [5]. Encephalopathy can lead to an autonomic neuropathy, which may precipitate arrhythmias or even sudden death [5].
- Type
- Chapter
- Information
- Handbook of Pediatric HIV Care , pp. 554 - 566Publisher: Cambridge University PressPrint publication year: 2006