Herpes Zoster-induced Progressive Heart Block: A Case Report

Abstract

Varicella-zoster virus (VZV) can produce painful, cutaneous lesions in human beings. Reactivation of this neurotropic virus leads to herpes zoster or shingles: a painful, unilateral, vesicular eruption in a restricted dermatomal distribution. Rarely, reactivation of this virus can lead to cardiac complications, such as myocarditis and even conduction abnormalities. In this case report, we present a patient with a cardiac complication post VZV reactivation and address an unusual question and concern resulting from latent VZV presentation in adults.

Not Just a Rash: Herpes Zoster-induced Progressive Cardiac Block

“…The progression of conduction abnormality preservation of chronotropic response in our patient may reflect a partial/complete block of the cardiac sympathetic ganglion, or a weakening of resting sympathetic tone. 8 Since there are neither direct neural nor vascular connections between the dorsal root ganglia and the cardiac parasympathetic/sympathetic ganglia, VZV reactivation can occur at the dorsal root ganglion as well as the cardiac sympathetic ganglia. However, VZV-induced conduction pathologies may be reversible if the underlying condition is managed properly.…”

“…Symptoms of heart block can include dizziness, fainting, shortness of breath, and chest pain, and anyone experiencing these symptoms should seek medical care immediately. 8 This case is a report of a patient that presented with a progressive conduction abnormality in the setting of shingles reactivation.…”

“…Symptoms of heart block can include dizziness, fainting, shortness of breath, and chest pain, and anyone experiencing these symptoms should seek medical care immediately. 8 …”

Herpes Zoster and Cardiovascular Disease: Exploring Associations and Preventive Measures through Vaccination

“…VZV has been documented to necessitate permanent pacemaker placement due to complete heart block [ 111 , 112 , 113 ] and lead to second-degree atrioventricular block [ 114 ]. The development of a complete heart block is believed to result directly from the reactivation of the virus within the cardiac sympathetic/parasympathetic ganglia [ 111 ].…”