Cardiovascular diseases during HIV infection are frequent and serious. The aim of this first study in Burkina Faso was to analyse cardiovascular affections in HIV-positive African patients, admitted to the adult cardiology unit of the Yalgado Ouedraogo National Hospital of Ouagadougou. We conducted a retrospective study of consecutive cases admitted to the cardiology unit between 1 January 1993 and 31 March 1999. The inclusion criteria were: progressive heart affection, positive HIV serology, and the absence of cardiovascular antecedents or pathology. We studied age, sex, clinical and complementary parameters (electrocardiogram, thoracic radiography, electrocardiography), treatment and evolution. 79 black Africans were included, 44 men and 35 women. The mean age was 36.3 +/- 9.8 years. The clinical presentation was principally heart failure (79% of cases). Myocarditis or cardiomyopathy was found in 45 cases (57%); isolated pericarditis--in 25 cases (32%); pulmonary hypertension--in 4 cases (5%); pulmonary embolism--in 3 cases; and myocardial infarction--in 2 cases. According to the Atlanta CDC classification for HIV infection, 70% of the patients where in stage C. The overall hospital mortality rate was 15%. Cardiac lesions were present principally with myocardium and pericardium, with high specific mortality.