Objective. To describe the echocardiographic findings in critically ill patients with AIDS and their impact on clinical outcome. Design. A retrospective chart review of consecutive AIDS patients over 18 years of age, who had a trans-thoracic echocardiogram performed during the course of intensive care unit stay over the course of 2 years at a tertiary care hospital. Main outcome measures. The prevalence of echocardiogram abnormalities in this population and its impact on ICU mortality, ICU length of stay, hospital mortality, hospital length of stay and 60 day survival. Results. Among 107 patients who met the inclusion criteria, an admission echocardiogram was performed in 62 (58%). The prevalence of cardiac abnormalities was 60%. The most common admission diagnosis was respiratory failure (43%). The most common finding on echocardiogram was left ventricular (LV) dysfunction (50%) followed by pulmonary hypertension (40%). None of these findings had a significant impact on clinical outcomes. There was trend toward reduced 60 day survival among patients with depressed LV function. Conclusions. Although echocardiogram abnormalities were prevalent among this population none of these findings had a significant impact on ICU mortality or hospital mortality and ICU length of stay or hospital length of stay. 1. Introduction The CDC estimates that 56,300 new HIV infections occurred in the United States in 2006 [1]. In the era of highly active antiretroviral therapy the mortality from HIV has been decreasing [2–6]. More patients are admitted to the intensive care unit for non-AIDS-associated illnesses than in the past [2, 5–8]. Advances in echocardiogram technology have provided the critical care physicians with a reliable and noninvasive method of determining cardiac function and chamber sizes and to detect the presence of valve diseases and pericardial disease. Due to its ready availability and noninvasive nature, echocardiography is commonly used in the critically ill population. A number of echocardiogram findings have been described in the noncritically ill HIV population with the most common ones being pericardial effusion, myocarditis, dilated cardiomyopathy, endocarditis, and pulmonary hypertension, while a recent prospective observational study showed that 18% of the HIV patients had systolic, 26% had diastolic dysfunction, and up to 57% had evidence of pulmonary hypertension based on TR jet velocity [9, 10]. Pericardial effusion has also been shown to predict increased mortality among HIV infected patients [11, 12]. Blanc et al. performed a prospective
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