[Cardiac involvement in Lyme disease]

Area of Science:

• Cardiology
• Infectious Diseases
• Immunology

Context:

• Cardiac manifestations of Lyme Borreliosis are infrequent but can occur early or late after infection.
• Early cardiac involvement is linked to direct spirochetal infection, while late-stage issues may stem from autoimmunity.
• Lyme carditis typically presents as atrioventricular block, but myocarditis, pericarditis, and arrhythmias can also occur.

Purpose:

• To summarize the clinical presentation, diagnosis, and management of cardiac involvement in Lyme Borreliosis.
• To highlight the typical presentation of fluctuating atrioventricular block and rarer forms like myocarditis or pericarditis.
• To emphasize that diagnosis relies on clinical and laboratory findings, with a suggestion for screening in young individuals with conduction disturbances.

Summary:

• Lyme carditis, a complication of Lyme Borreliosis, usually presents as transient atrioventricular block, but can also manifest as myocarditis or pericarditis, sometimes mimicking acute myocardial infarction.
• Diagnosis involves clinical suspicion, especially in young individuals with conduction abnormalities, alongside standard Lyme disease diagnostics.
• Complete recovery is common, with treatment involving antibiotics like doxycycline or ceftriaxone, similar to non-cardiac Lyme disease.

Impact:

• Provides a concise overview of Lyme carditis for clinicians and researchers.
• Underscores the importance of considering Lyme disease in patients with unexplained cardiac conduction abnormalities.
• Reinforces that Lyme carditis is generally treatable and has a good prognosis with appropriate antibiotic therapy.