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The following electronic only articles are published in conjunction with this issue of Heart.

Paracardial lipodystrophy versus pericardial effusion in HIV positive patients

T Neumann, J Barkhausen, T Bartel

Objective: To present an epicardial manifestation of the lipodystrophy syndrome, a side effect of antiretroviral treatment in HIV positive patients, which illustrates the important danger of false diagnosis.

Patient: A 52 year old man with HIV (stage C3), diagnosed 10 years previously, was being treated with a combination of nelfinavir, nevirapine, and stavudine. Echocardiographic examination showed a low echogenic pericardial space that had increased tremendously from 4 mm to 18 mm over a 10 month period. The diagnosis of paracardial adipose tissue was verified by magnetic resonance tomography. Doppler echocardiographic parameters were not significantly altered (ratio of early to late ventricular filling 0.88 v 0.73, Tei index 0.30 v 0.36).

Conclusion: Even a pericardial manifestation of lipodystrophy causes negligible functional . . . [Full text of this article]

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