Dilated Cardiomyopathy

The reported prevalence of this heart condi­tion ranges between 5 and 23% of autopsy studies [1-3].

Pathologic Features

Pathologic features of AIDS-related car­diomyopathy are similar to those observed in seronegative patients.

On the cut surface, the ventricles show an eccentric hypertrophy, that is, a mass increase with chamber volume enlarge­ment. Although hypertrophy is demonstrat­ed by the increase in cardiac weight, this is not always grossly evident owing to ventric­ular dilation; the free wall width may be normal, or even thinner than normal, as happens in short-term survivors. Endocar­dial fibrosis is a common finding, as well as mural thrombi, mainly located at the apex. Dilated cardiomyopathy can be associated with pericardial effusion or infective endo­carditis, especially in intravenous drug abusers [1].

On histology, myocytes show variable degrees of hypertrophy and degenerative changes such as myofibril loss, causing hydropic changes within the myocyte. An increase in interstitial and endocardial fib­rillar collagen is a constant feature in this cardiomyopathy [1-3].