Human Immunodeficiency Virus - Assocciated Hyperthropic Cardiomyopathy Presenting with Chest Pain Suspected with Acute Myocarditis: An Unusual Case Report

Abstract Background: Human Immunodeficiency Virus-associated cardiomyopathy (HIVAC) is a stage 4 disease that is linked to HIV and is still a major cause of illness and death in people who have HIV. The cause of HIVAC and how it shows up in the body depend on how weak the host's immune system is. Myocarditis caused by direct HIV toxicity, opportunistic diseases, and food deficiencies may be a cause of HIVAC. We describe a woman with a low CD4 count who had severe dilated cardiomyopathy caused by HIV. Case Presentation: A 40-year-old female with HIV receiving antiretroviral therapy presented with severe chest pain that began two hours before hospital admission. Complaints were linked to perspiration and shortness of breath. The vital signs revealed a blood pressure of 80/50 mmHg, a heart rate of 85 bpm, and a respiratory rate of 25 brpm. The electrocardiogram revealed normal sinus rhythm with anteroseptal old myocardial infarction, while echocardiography showed left ventricular hypertrophy, a 77% ejection fraction, septal thickening with asynergic ventricular regions in the inferolateral area, and a suspicion of myocarditis. The CD4 count at admission was reduced to 144 cells/mm3, and the high sensitivity troponin level was increased. She initiated inotropic and vasopressor therapy, a maintenance protocol of dual antiplatelet medicines, anticoagulants, heart failure care, and steroid treatment. After five days of therapy, the patient's symptoms improved, and a referral for magnetic resonance imaging (MRI) was arranged to validate the diagnosis of acute myocarditis. Conclusion: This instance underscores the significance of antiretroviral therapy (ART) in sustaining adequate CD4 counts and suppressing elevated viral loads to avert opportunistic infections, perhaps serving as a crucial factor in HIVAC.