Related Experiment Video
Updated: Sep 20, 2026
Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
Published on: February 4, 2018
Lyme disease and the heart
Fadi A Haddad1, Robert B Nadelman
1Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, New York 10595, USA.
Insights
Lyme carditis, an infection by Borrelia burgdorferi, causes heart rhythm issues. Early diagnosis and treatment of Lyme disease improve outcomes and prevent complications.
Area of Science:
- Infectious Diseases
- Cardiology
- Epidemiology
Background:
- Lyme carditis is a cardiac manifestation of Lyme disease, caused by Borrelia burgdorferi.
- It typically presents as atrioventricular block weeks after infection, though myocarditis and pericarditis can also occur.
- Cardiomyopathy linked to B. burgdorferi is reported in Europe, but not the US.
Purpose of the Study:
- To review the clinical presentation, diagnosis, and management of Lyme carditis.
- To emphasize the importance of considering Lyme disease in patients with unexplained cardiac symptoms.
- To highlight diagnostic criteria and treatment strategies for Lyme carditis.
Main Methods:
- Review of clinical literature on Lyme carditis.
- Analysis of diagnostic approaches, including patient history and laboratory testing.
- Evaluation of treatment outcomes and prognosis.
Main Results:
- Lyme carditis presents with atrioventricular block, myocarditis, or pericarditis.
- Diagnosis relies on clinical suspicion (travel history, rash, symptoms) and serological testing.
- Absence of tick bite or rash does not exclude Lyme disease.
- Concurrent erythema migrans or positive 2-step antibody testing supports diagnosis.
- Clinical judgment is crucial due to potential false positives.
Conclusions:
- Lyme carditis generally resolves spontaneously.
- Antimicrobial therapy can shorten symptom duration and prevent sequelae.
- The prognosis for Lyme carditis is excellent with appropriate management.
Abstract:
Lyme carditis is typically characterized by varying degrees of intermittent atrioventricular block occurring within weeks of infection with Borrelia burgdorferi. Myocarditis and/or pericarditis may occur. Cardiomyopathy has been associated with B. burgdorferi in Europe, but not in the United States. Patients with unexplained atrioventricular block or myopericarditis should be questioned for recent travel to tick-endemic areas, and for a history of erythema migrans rash, "viral-like" illness, aseptic meningitis, cranial nerve palsy, radiculitis, or oligoarthritis. However, the absence of a recognized tick bite or rash does not rule out Lyme disease. The diagnosis of Lyme carditis should be supported by the presence of concurrent erythema migrans, or by positive results of 2-step laboratory testing for antibodies to B. burgdorferi. False positive results may occur, emphasizing the importance of clinical judgment in attributing specific manifestations to B. burgdorferi infection. Carditis generally resolves spontaneously, but antimicrobial therapy can shorten symptom duration and prevent potential cardiac and non-cardiac sequelae. Cardiac manifestations generally resolve spontaneously, but antimicrobial therapy can shorten symptom duration and prevent potential cardiac and non-cardiac sequelae. The prognosis for Lyme carditis is excellent.
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:23Rheumatic Heart Disease I: Introduction
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:15Layers of the Heart Wall
The myocardium, the thickest layer, consists of cardiac muscle cells interconnected by intercalated discs and crisscrossing connective tissue fibers. These muscle fibers contract...
01:21Myocarditis I: Introduction
01:21Rheumatic Heart Disease III: Medical Management