A CASE REPORT OF NEWLY DIAGNOSED HIV PRESENTING WITH DILATED CARDIOMYOPATHY AND ISCHAEMIC STROKE AT FEDERAL MEDICAL CENTRE, OWO

Background: HIV as a cardiovascular risk factor has undergone back and forward debates. Objectives: To emphasise that HIV is a cardiovascular risk factor and an ounce of prevention is key. Case report: A 34 years old lady presented with 3months history of cough, recurrent fever and exertional dyspnoea, 2 weeks history of passage of frequent loose stool and sudden onset of weakness of left upper and lower limbs a day prior to presentation. Genotype AS, not a known hypertensive or diabetes and she neither smoke nor take alcohol or any recreational drug. Examination revealed a young lady, conscious, wasted, afebrile, no finger clubbing but has bilateral pitting pedal oedema. Neurological findings includes left facioparesis UMN, initial hypotonia and hyporeflexia with power 0 in the left upper and lower limbs with extensor planter response but became hyperreflexia with progressive improvement in the power and tone. Cardiovascular examination revealed tachycardia 108/m, BP 120/80mmHg, elevated JVP, apex beat at 6LICS AAL with s1 s2 s3. There was tachpnoea, bibasal coarse crackles and mild hepatomegaly. Diagnosis of HIV confirmed by polymerase chain reaction (PCR). Brain computerized tomography (CT) scan revealed a hypodense lesion at the right middle cerebral artery territory and echocardiography revealed dilated cardiac chambers with global hypokinesia, left ventricular ejection fraction (EF) 35%, biventricular diastolic dysfunction and moderate mitral and tricuspid regurgitation. She made significant recovery of neurological deficit and achieve good exercise tolerance after 3 months of HAART. Conclusion: A newly diagnosed case of HIV in a young lady with no other identifiable cardiovascular risk factor, presenting with dilated cardiomyopathy and ischaemic stroke is remarkable.