Well it seems the MSVS bug of failing to recompile headers after changes have been made is not isolated to pre-compiled headers.
Just today I was setting some u,v coords in a constructor for a structure in a header file and was seeing no changes when I pressed F5 or CTRL F5. It was not until a complete rebuild of the solution or project that my code changes actually took effect.
Any reason why headers might do this besides it just being a bug? I don't think I've encountered this in any other compiler to date.