Biventricular thrombi in dilated cardiomyopathy in a patient with human immunodeficiency virus infection: a case report.
BACKGROUND
Sub-Saharan Africa is undergoing epidemiological transition with an increase in the prevalence of cardiovascular diseases that will add to the already devastating burden of infectious diseases such as human immunodeficiency virus infection. Human immunodeficiency virus infection is increasingly being recognized as an important etiological factor for dilated cardiomyopathy with the potential complication of intraventricular thrombus. However, biventricular thrombi are extremely rare. We report on a rare finding of biventricular thrombi in dilated cardiomyopathy in a patient with human immunodeficiency virus infection in Cameroon.


METHODS
A 52-year old Cameroonian male patient with human immunodeficiency virus infection since 4 years, longstanding heavy alcohol consumption and cigarette smoking presented with gradually worsening shortness of breath, fatigue, persistent dry cough and lower extremity swelling of about two weeks duration. Congestive heart failure was diagnosed. Echocardiography showed left ventricular chamber enlargement with severe left ventricular systolic dysfunction and biventricular thrombi. The thrombi were immobile and regular in configuration, suggesting they were old. He was treated with a conventional heart failure treatment including loop diuretics and angiotensin converting enzyme inhibitors and anticoagulants for the biventricular thrombi. Six months later, a control echocardiography showed a significant decrease in the size of the thrombi. There was no evidence of systemic or pulmonary embolization during follow up.


CONCLUSIONS
Dilated cardiomyopathy may be seen in patients with human immunodeficiency virus infection, although other mechanisms needs to be assessed, but the occurrence of biventricular thrombi is rare.
Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon. cnkoke@yahoo.com.
Clovis
C
Nkoke
Cardiology Unit, Yaounde Central Hospital, Yaounde, Cameroon. mfeukeuliliane@yahoo.fr.
Liliane Mfeukeu
LM
Kuate
Centre for Population Studies and Health Promotion, CPSHP, Yaounde, Cameroon. lebaiins@gmail.com.|Department of Military Health, Ministry of Defense, Yaounde, Cameroon. lebaiins@gmail.com.
Engelbert Bain
EB
Luchuo
Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon. ediesandrine@yahoo.fr.
Sandrine Dikosso
SD
Edie
Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon. boombhijerome@yahoo.fr.
Jerome
J
Boombhi
Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon. amenanga@yahoo.fr.
Alain
A
Menanga
D002163:Cameroon; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000473:pathology; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging; D014463:Ultrasonography