title: Cardiac manifestations in HIV infected children.
abstract: OBJECTIVE
  To determine the occurrence of cardiac involvement in HIV infected children and describe its spectrum using non-invasive tests like ECG and 2-Dimensional Echocardiography (2-D ECHO).
  
  
  METHODS
  A cross sectional observational study was carried out on 100 HIV infected children between 1 and 18 y of age. The various cardiac manifestations were determined clinically, by electrocardiogram (ECG) and 2-D echocardiography.
  
  
  RESULTS
  Seventy four percent of the patients were males with a mean age of 9.62 ± 3.62 y. Seventy seven percent children were in WHO stage I. Sixty five percent did not have significant immune suppression. Eighty six percent children were on HAART (mean duration- 35.12 ± 29.48 mo). Fifty nine percent of children were symptomatic and only nine patients were clinically suspected to have cardiac involvement. ECG abnormalities were found in 14 % cases. The most common abnormal echocardiographic finding was left ventricular diastolic dysfunction by tissue Doppler (E/E') observed in 64 % cases followed by systolic dysfunction (37 %), abnormal left ventricular mass (29 %), pericardial effusion (2 %) and dilated cardiomyopathy (2 %); 64.2 % cases with left ventricular systolic dysfunction (LVSD) were in WHO stage III.
  
  
  CONCLUSIONS
  Involvement of heart in HIV/AIDS is mostly subclinical. HIV myocarditis produces systolic as well as diastolic dysfunction. At present, echocardiography remains the only tool for identifying heart involvement in HIV-infected children. Early diagnosis and intervention may halt the progression of the disease, thereby preventing morbidity and mortality.
authors.affiliation: Department of Pediatrics and Neonatology, PGIMER and Ram Manohar Lohia Hospital, Delhi, 110001, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Singh
authors.forename: Alok
authors.initials: A
authors.lastname: Hemal
authors.forename: Sheetal
authors.initials: S
authors.lastname: Agarwal
authors.forename: Dinesh
authors.initials: D
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D058070:Asymptomatic Diseases / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D061345:Early Medical Intervention; D004452:Echocardiography / Q000379:methods; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D011379:Prognosis