Cardiac diseases in AIDS medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
===Pericarditis=== | |||
Majority of the [[AIDS]] patients with [[pericarditis]] are asymptomatic. Small [[pericardial effusion]]s without [[tamponade]] can be followed up without any further testing. In symptomatic patients with large effusions with or without a tamponade, [[pericardiocentesis]] is indicated to obtain culture and cytology. If tamponade occurs, immediate drainage is necessary. | Majority of the [[AIDS]] patients with [[pericarditis]] are asymptomatic. Small [[pericardial effusion]]s without [[tamponade]] can be followed up without any further testing. In symptomatic patients with large effusions with or without a tamponade, [[pericardiocentesis]] is indicated to obtain culture and cytology. If tamponade occurs, immediate drainage is necessary. | ||
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Pericarditis secondary to [[lymphoma]] can be treated with radiation and/or [[chemotherapy]]. However, combination chemotherapy has been shown to significantly increase the risk of early death from opportunistic infections. | Pericarditis secondary to [[lymphoma]] can be treated with radiation and/or [[chemotherapy]]. However, combination chemotherapy has been shown to significantly increase the risk of early death from opportunistic infections. | ||
===Heart Failure=== | |||
Treatment of [[heart failure]] in patients with AIDS is similar to that of in general population. [[ACE inhibitor]]s, [[diuretic]]s, [[beta-blocker]]s and [[digoxin]] are indicated as usual. Also, drugs that are known to cause cardiac side effects should be discontinued. | Treatment of [[heart failure]] in patients with AIDS is similar to that of in general population. [[ACE inhibitor]]s, [[diuretic]]s, [[beta-blocker]]s and [[digoxin]] are indicated as usual. Also, drugs that are known to cause cardiac side effects should be discontinued. | ||
Revision as of 18:18, 1 July 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Medical Therapy
Pericarditis
Majority of the AIDS patients with pericarditis are asymptomatic. Small pericardial effusions without tamponade can be followed up without any further testing. In symptomatic patients with large effusions with or without a tamponade, pericardiocentesis is indicated to obtain culture and cytology. If tamponade occurs, immediate drainage is necessary.
It is recommended that patients with pericarditis of unknown etiology be treated emperically for Mycobacterium tuberculosis. Addition of perdnisolone to anti-tubercular therapy is associated with rapid recovery, lower mortality rates and decreased need for surgical intervention.
Bacterial and fungal causes of pericarditis are treated with appropriate anti-bacterials and anti-fungals.
Pericarditis secondary to lymphoma can be treated with radiation and/or chemotherapy. However, combination chemotherapy has been shown to significantly increase the risk of early death from opportunistic infections.
Heart Failure
Treatment of heart failure in patients with AIDS is similar to that of in general population. ACE inhibitors, diuretics, beta-blockers and digoxin are indicated as usual. Also, drugs that are known to cause cardiac side effects should be discontinued.
Lifestyle modification (smoking cessation, weight reduction) and control of hypertension, diabetes and elevated cholesterol should be paid special attention.