A. Pericardial Effusion
Pericardial disease is the most common cardiac compli¬cation of HIV infection and it causes approximately 60% of all cardiac pathology. Figure 1 shows HIV cardiac complications. Approximately 5% of individuals infected with HIV show echocardiographic evidence of pericardial effusions. In more than 75% of cases pericardial effusions are small and usually asymptomatic, but they indicate advanced disease and poor prognosis. Pericardial effusions may compress the heart, cause cardiac tamponade, and prevent adequate filling which results in a marked fall in blood pressure, cardiogenic shock, and death. In approxi¬mately 30% of patients the effusion resolves spontaneously. The disease of the pericardium may be caused by the following types of infections.
1. Viruses: cytomegalovirus (CMV), HIV, herpes simplex
2. Bacterial: Staphylococcus aureus, Streptococcus pneumo-niae, Klebsiella pneumoniae, mycobacteria
3. Fungi: Cryptococcus neoformans
4. Neoplastic involvement: malignant lymphoma; Kaposi’s sarcoma may involve both the pericardium and epicardial fat
The first case of cardiac involvement was reported in 1983 in a 24-year-old Haitian woman with extensive Kaposi’s sarcoma that involved the entire anterior wall of the heart muscle.

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