背景:心脏填塞是一种危及生命的疾病,需要及时诊断和治疗干预。人类免疫缺陷病毒(HIV)感染患者的心脏压塞的诊断和管理对临床医生构成了重大挑战。本研究旨在探讨临床特点,临床旁发现,治疗选择,患者结果,以及艾滋病毒携带者心脏压塞的病因。
方法:发布,Embase,Scopus,系统检索了截至2024年2月29日有心脏压塞的HIV感染患者的病例报告或病例系列。基线特征,临床表现,临床旁发现,治疗选择,患者结果,和心包填塞的病因由两名评论者独立提取。
结果:共纳入了37篇报道40例HIV阳性心脏压塞患者的文章。这些患者主要经历呼吸困难,发烧,胸痛,还有咳嗽.他们大多表现出异常的生命体征,如呼吸急促,心动过速,发烧,和低血压。体格检查主要显示颈静脉压升高(JVP),低沉的心音,和掌悖论。超声心动图多提示心包积液,右心室塌陷,右心房塌陷.大多数患者接受了心包穿刺术,而其他人做了开胸手术,心包切开术,和心包造口术.此外,感染和恶性肿瘤是HIV阳性患者心脏压塞最常见的病因,分别。最终,80.55%的患者存活,其余的过期。
结论:感染和恶性肿瘤是HIV阳性患者心脏压塞的最常见原因。如果这些患者表现出心脏压塞的临床表现,临床医师应及时进行超声心动图诊断。他们还应该接受心包液引流并接受额外的治疗,根据病因,以降低死亡率。
BACKGROUND: Cardiac tamponade is a life-threatening condition requiring prompt diagnosis and therapeutic intervention. Diagnosis and management of cardiac tamponade in patients with human immunodeficiency virus (HIV) infection pose a major challenge for clinicians. This study aimed to investigate clinical characteristics, paraclinical findings, therapeutic options, patient outcomes, and etiologies of cardiac tamponade in people living with HIV.
METHODS: Pubmed, Embase, Scopus, and Web of Science databases were systematically searched for case reports or case series reporting HIV-infected patients with cardiac tamponade up to February 29, 2024. Baseline characteristics, clinical manifestations, paraclinical findings, therapeutic options, patient outcomes, and etiologies of cardiac tamponade were independently extracted by two reviewers.
RESULTS: A total of 37 articles reporting 40 HIV-positive patients with cardiac tamponade were included. These patients mainly experienced dyspnea, fever, chest pain, and cough. They were mostly presented with abnormal vital signs, such as tachypnea, tachycardia, fever, and hypotension. Physical examination predominantly revealed elevated Jugular venous pressure (JVP), muffled heart sounds, and palsus paradoxus. Echocardiography mostly indicated pericardial effusion, right ventricular collapse, and right atrial collapse. Most patients underwent
pericardiocentesis, while others underwent thoracotomy, pericardiotomy, and pericardiostomy. Furthermore, infections and malignancies were the most common etiologies of cardiac tamponade in HIV-positive patients, respectively. Eventually, 80.55% of the patients survived, while the rest expired.
CONCLUSIONS: Infections and malignancies are the most common causes of cardiac tamponade in HIV-positive patients. If these patients demonstrate clinical manifestations of cardiac tamponade, clinicians should conduct echocardiography to diagnose it promptly. They should also undergo pericardial fluid drainage and receive additional therapy, depending on the etiology, to reduce the mortality rate.