These studies reveal that in mice, Coxsackie B4 and EMC viruses produce not only myocardial disease but extensive disease of the myocardial capillaries, coronary arteries, aorta and mesenteric arteries and veins and other arteries and veins. These lesions impair luminal calibre and, in turn, lead to myocardial ischaemia. This ischaemia contributes further to the myocardial damage. It is postulated that viruses initiate arteriosclerosis in man. A 19-year-old man who died of Coxsackie B4 viral cardiomyopathy had changes in the aorta noted on light and electron microscopy which are compatible with atherosclerosis. The relationship of these aortic changes to the viral infection can only be opened to speculation. Nevertheless, all of these studies establish a new concept of the possible initiating cause of arteriosclerosis, a common and extremely important disease of man.
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