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A young healthy male with syncope and complete heart block

V Chauhan1, N Chauhan, C G S Chauhan

  • 1Department of Medicine, Drexel University College of Medicine & Hahnemann University Hospital, 245 N.15th Street, Philadelphia, PA 19102, USA.veeraish@yahoo.com

Scottish Medical Journal
|June 4, 2013
PubMed

Insights

Heart block as the sole initial symptom of Lyme disease is uncommon. Prompt diagnosis and treatment with ceftriaxone can resolve Lyme carditis, avoiding unnecessary pacemaker implantation.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Diagnostics

Background:

  • Lyme disease rarely presents solely with heart block (1% incidence).
  • Isolated Lyme carditis poses diagnostic challenges due to lack of typical Lyme disease stigmata.

Observation:

  • A patient experienced syncope due to fluctuating heart block without prior Lyme disease manifestations.
  • Lyme carditis was suspected after excluding other common causes of heart block.

Findings:

  • Positive Lyme disease serologies confirmed the diagnosis.
  • The patient's heart block resolved completely following treatment with ceftriaxone.

Implications:

  • Clinicians should consider Lyme carditis in at-risk individuals presenting with heart block to avoid invasive procedures like permanent pacemaker implantation.
  • Early diagnosis and treatment of Lyme carditis prevent potential late-stage Lyme disease complications and reduce healthcare costs.
Abstract

Keywords:
Borrelia burgdorferiLyme diseaseheart blocklyme carditispacemakervector borne disease

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