Varicella myopericarditis mimicking myocardial infarction in a 17-year-old boy

Aliva De, Dorothy Myridakis, Margot Kerrigan, Fuad Kiblawi

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Varicella (chickenpox), a common childhood infection caused by the varicella-zoster virus, is self-limiting and usually benign. Although atypical manifestations of the virus are occasionally seen, it rarely presents with cardiovascular sequelae. Cardiovascular complications of varicella can include pericarditis, myocarditis, or endocarditis. Herein, we report the case of a 17-year-old boy who had varicella infection and severe chest pain. Examination revealed atypical electrocardiographic findings of pericarditis and remarkably elevated cardiac biomarker levels: peak cardiac troponin I, 37.2 ng/mL; total creatine kinase, 1,209 U/L; and creatine kinase-MB fraction, 133.6 ng/mL. After results of coronary angiography reliably excluded ischemia and myocardial infarction, the diagnosis was varicella myopericarditis. The patient was placed on a medical regimen during and after 5 days of hospitalization. In 2 weeks, he was asymptomatic, and at 6 months, he was doing well and had normal electrocardiographic and echocardiographic results. To our knowledge, cardiac enzyme elevations to these levels have not been reported in cases of cardiovascular sequelae of varicella. We discuss the diagnostic challenges of this atypical case and suggest that clinicians be aware that varicella disease is most often, but not always, benign.

Original languageEnglish (US)
Pages (from-to)288-290
Number of pages3
JournalTexas Heart Institute Journal
Volume38
Issue number3
Publication statusPublished - Jul 11 2011

    Fingerprint

Keywords

  • Adolescent
  • Cardiovascular diseases/virology
  • Chest pain/etiology
  • Chickenpox/complications
  • Diagnosis
  • Differential
  • Echocardiography
  • Myocarditis/etiology/pathology/therapy/virology
  • Pericarditis/etiology/pathology/therapy/virology
  • Treatment outcome
  • Troponin i/blood

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

De, A., Myridakis, D., Kerrigan, M., & Kiblawi, F. (2011). Varicella myopericarditis mimicking myocardial infarction in a 17-year-old boy. Texas Heart Institute Journal, 38(3), 288-290.