HIV / AIDS & Heart Diseases - Fred Perry Kemah

Dear Community,

Lack of Internet back at home in our territories means a lot. Firstly, Junior and inexperienced  medics will definitely find it hard to practice telemedicine.

Our role is to provide support and advice to colleagues back home via  Internet services when treating patients presenting  with complex cases.

Lack of Internet could translate to indirect increase of  avoidable deaths in our deprived territories.

Therefore,  I am taking the liberty of reminding our people about the cardiovascular  complications of Patients  infected  with HIV / AIDS despite on anti HIV/AIDS treatment regime.

From a cardiac perspective the end stage of all patients infected with HIV/AIDS is Heart Failure.

There is also an element of systemic inflammation.

So, patients could present with breathlessness and easy fatigue because of increased pulmonary pressure, irregular  heart rhythm , such as AF then Stroke.

What has prompted me to create this  reminder is the case of an HIV infected patient seen by a junior doctor in Kribi who presented with breathlessness and signs of heart failure.

We identified large amount of fluid in the sac containing the heart. This condition known as PERICARDIAL EFFUSION is caused by inflammation of the sac containing the heart, lubricating and preventing it from trauma.

Chronic inflammation in HIV / AIDS patients will result in abnormal increase of the effusion, breathlessness , easy fatigue and the risk of sudden death.

In summary HIV/ AIDS patients despite on triple antiretroviral regime are still at risk of major adverse cardiac events.

Therefore,  regular follow up with imaging modalities seems appropriate with a view to preventing sudden death. 

Lack of Internet in our territories means that people will inevitably die prematurely and of course some will be the victims of avoidable deaths.

The essence of this narrative is to follow suit from our colleague in Kribi. If you are a medic facing a complex case, get a good history and exam findings plus  images and send to us here  for assistance.

With Best Wishes.

Fred Perry Kemah, MD, PhD, FRCP, FESC
Consultant Cardiologist
Honorary Senior Lecturer in Cardiac Medicine.
London, UK

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