Heart stopping tick

Area of Science:

• Cardiology
• Infectious Diseases
• Pediatrics

Background:

• Lyme carditis is an uncommon cardiac manifestation of Lyme disease, typically occurring 4-6 weeks post-exposure.
• Complete atrioventricular (AV) block is a rare but serious complication of Lyme carditis.
• Early recognition and treatment are crucial to prevent long-term cardiac sequelae.

Purpose of the Study:

• To report a case of complete AV block as the initial presentation of Lyme disease in a young male.
• To emphasize the importance of considering Lyme carditis in the differential diagnosis of new-onset complete AV block.
• To highlight the efficacy of timely antibiotic therapy in achieving complete recovery and preventing pacemaker insertion.

Main Methods:

• Case report of a 17-year-old male presenting with chest discomfort.
• Diagnostic workup including evaluation for infectious etiologies.
• Treatment with empiric intravenous ceftriaxone for suspected Lyme disease.

Main Results:

• The patient presented with chest discomfort and was diagnosed with complete AV block.
• Lyme carditis was identified as the cause of the complete AV block.
• The patient experienced an uneventful recovery after treatment with ceftriaxone.

Conclusions:

• Complete AV block can be the sole presenting sign of disseminated Lyme disease.
• Prompt diagnosis and treatment of Lyme carditis with antibiotics can reverse complete AV block.
• Considering Lyme disease in the differential diagnosis for complete AV block can prevent unnecessary permanent pacemaker implantation.