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Year : 2018  |  Volume : 28  |  Issue : 4  |  Page : 245

Biatrial myxoma and human immunodeficiency virus infection: An association not to be missed

Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Web Publication24-Dec-2018

Correspondence Address:
prof Mahmood Dhahir Al-Mendalawi
P.O. Box 55302, Baghdad Post Office, Baghdad
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcecho.jcecho_21_18

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How to cite this article:
Al-Mendalawi MD. Biatrial myxoma and human immunodeficiency virus infection: An association not to be missed. J Cardiovasc Echography 2018;28:245

How to cite this URL:
Al-Mendalawi MD. Biatrial myxoma and human immunodeficiency virus infection: An association not to be missed. J Cardiovasc Echography [serial online] 2018 [cited 2020 Jun 1];28:245. Available from: http://www.jcecho.org/text.asp?2018/28/4/245/248407

Dear Sir,

I read with interest the case report by Barik on biatrial myxoma (BM) with triple ripples in an Indian patient.[1] The author nicely described the clinical picture as well as imaging and histopathologic findings in the studied patient. I presume that the rare occurrence of BM with triple ripples should trigger the author to consider human immunodeficiency virus (HIV) infection in the studied patient. My presumption is based on the following point. It is obvious that individuals infected with HIV are more prone to various types of tumors compared to those with healthy immune system. The increased vulnerability of HIV-positive individuals to have tumors has been attributed to different factors, including immunosuppression, coinfection with oncogenic viruses, and life prolongation secondary to the use of antiretroviral therapy.[2] As longevity improves in HIV-infected patients after the institution of highly active antiretroviral treatment (HAART) regimens, various cardiovascular complications in patients with HIV infection are expected to be encountered. These complications are caused by the HIV infection itself, opportunistic infections, HIV-related tumors, and the side effects of HAART.[3] Among HIV-associated tumors, atrial myxoma has been reported. The first report of atrial myxoma in a 50-year-old HIV-positive woman was published by Shaw and Mclean in 2000. The patient had a postembolic myocardial infarction with normal coronaries proved by angiography. Myxoma was diagnosed while evaluating a syncopal attack, and the tumor was resected surgically in spite of low CD4 count.[4] To my knowledge, HIV infection is a hazardous health issue in India. The available data pointed out to 0.26% HIV seroprevalence compared with a global average of 0.2%.[5] I presume that the author did not consider underlying HIV infection in the studied patient. This is obvious as the author mentioned that “routine workup showed normal leukocyte count, hematocrit, erythrocyte sedimentation rate, coagulation profile, kidney function test, thyroid function test, normal blood glucose level, and normal chest X-ray.”[1] Hence, the determination of HIV status in the studied patient through the diagnostic set of viral overload and blood CD4 count measurements was envisaged. If that diagnostic set was accomplished and it showed HIV infection, the case in question could be confidently considered a novel case report. This is because HIV-associated BM with three ripples has never been reported in the literature so far.

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  References Top

Barik R. A biatrial myxoma with triple ripples. J Cardiovasc Echogr 2018;28:59-60.  Back to cited text no. 1
Valencia Ortega ME. Malignancies and infection due to the human immunodeficiency virus. Are these emerging diseases? Rev Clin Esp 2018;218:149-55.  Back to cited text no. 2
Nakazono T, Jeudy J, White CS. HIV-related cardiac complications: CT and MRI findings. AJR Am J Roentgenol 2012;198:364-9.  Back to cited text no. 3
Shaw AJ, Mclean KA. Atrial myxoma and HIV infection. Sex Transm Infect 2000;76:144.  Back to cited text no. 4
Paranjape RS, Challacombe SJ. HIV/AIDS in India: An overview of the Indian epidemic. Oral Dis 2016;22 Suppl 1:10-4.  Back to cited text no. 5


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