Rapidly Progressive HIV-Associated Dilated Cardiomyopathy Presenting with Heart Failure: A Case Report
Abstract
RetaCardiomyopathy related to human immunodeficiency virus (HIV) infection is an uncommon but important cause of heart failure in young people and is frequently late recognised . We report the case of a young woman with HIV infection diagnosed in 2021 and treated with combination antiretroviral therapy, who presented with progressive breathlessness, tachycardia and hypotension. Echocardiography showed a dilated, globally hypokinetic left ventricle with severely reduced ejection fraction. Her condition deteriorated over the following weeks, and a multidisciplinary decision was taken to interrupt antiretroviral therapy while heart failure treatment was intensified. Persistent hypotension prevented the introduction of an angiotensin receptor-neprilysin inhibitor and a beta-blocker, and treatment was limited to ivabradine, torsemide, a mineralocorticoid receptor antagonist and empagliflozin. Partial improvement in left ventricular systolic function and reverse remodelling followed. This case illustrates the difficulty of separating HIV-related myocardial injury from antiretroviral cardiotoxicity, and the practical limits of guideline-directed therapy in the hypotensive patient.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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