title: Herpes zoster and its cardiovascular complications in the elderly--another look at a dormant virus.
abstract: Herpes zoster (shingles) is a reactivation of latent Varicella-zoster virus (VZV). We present a case of pleuropericarditis simulating acute myocardial infarction and another with complete heart block in the setting of acute/recent VZV reactivation. These cases are consistent with a modified concept: (1) the VZV dormancy is comprised of multiple foci of infections in the sensory and autonomic ganglia, and (2) the VZV reactivation could involve co-incident activations of two or more loci. Recognition of this possibility of cardiovascular complications of VZV should be helpful in the clinical management of the elderly, in the differential diagnosis of chest pain, ST elevation, and heart block etiology in the setting of acute or recent VZV reactivation.
authors.affiliation: Section of Cardiology, Department of Medicine, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX 77030, USA. tma@bcm.tmc.edu
authors.forename: Tony S
authors.initials: TS
authors.lastname: Ma
authors.forename: Tracie C
authors.initials: TC
authors.lastname: Collins
authors.forename: Gabriel
authors.initials: G
authors.lastname: Habib
authors.forename: Audrius
authors.initials: A
authors.lastname: Bredikis
authors.forename: Blase A
authors.initials: BA
authors.lastname: Carabello
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000821:virology*; D003937:Diagnosis, Differential; D006562:Herpes Zoster / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged