In the pre-HAART era, HIV related heart disease was described as an often underlooked consequence of the infection. Heart disease of non-infectious etiology unmasked by the clinical management of HIV is more often described. The signs and symptoms of heart disease when present portend a poor prognosis. This study sought to document the magnitude of cardiac involvement in Ugandan HIV patients. The objective was to determine prevalence, describe the clinical, echocardiographic and electrocardiographic presentations of heart disease amongst HIV positive adults attending a clinic (IDC) during the study period between September and December 2003.