New cases of Human Immunodeficiency Virus (HIV) infection are becoming more prevalent in Wisconsin. As advances in HIV treatment have improved patient survival, more individuals are living with this disease. Consequently, previously uncommon manifestations, such as cardiac complications, are likely to be encountered in clinical practice more often. In general, cardiac manifestations in patients with HIV infection are clinically subtle in their initial stages. Symptoms are usually nonspecific; however, dyspnea is very common and may be overlooked or attributed to pulmonary diseases and opportunistic infections. Cardiac abnormalities in HIV infection may involve any of the structures of the heart including pericardium, myocardium, and endocardium. Furthermore, HIV infection is associated with pulmonary hypertension, cardiac neoplasms, and use of potentially cardiotoxic medications. This article reviews the clinical cardiac manifestations currently seen in patients with HIV infection. Most of the cardiac complications were identified in the era before highly-active antiretroviral therapy, however, new complications have also been observed. To further reduce morbidity and mortality caused by HIV, early recognition and prompt intervention of cardiac diseases is extremely important. Further delineation of the natural history and clinical trials of the treatment of cardiac complications in patients with HIV infection are need given recent advances in antiretroviral therapy.