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Possible Lyme Carditis with Sick Sinus Syndrome.
Brian Cheung1, Larry Lutwick2, Michelle Cheung3
1Saint Bernards Healthcare, 300 Carson St., Jonesboro, AR, 72401, United States.
Idcases
|May 6, 2020
Summary
This case study highlights a rare presentation of Lyme carditis, focusing on sick sinus syndrome (SSS) without atrioventricular block (AVB) in a Lyme disease patient. It emphasizes considering Lyme carditis in endemic areas with new-onset bradycardia.
Area of Science:
- Infectious Diseases
- Cardiology
- Neurology
Background:
- Lyme disease, caused by *Borrelia burgdorferi*, is transmitted by *Ixodes* ticks and can lead to Lyme carditis.
- Lyme carditis commonly presents with bradycardia due to atrioventricular block (AVB).
Observation:
- A 47-year-old man with Lyme disease presented with headache, new-onset bradycardia, and right cranial nerve VI palsy causing diplopia.
- Diagnostic tests confirmed *Borrelia burgdorferi* infection.
- Electrocardiography (EKG) revealed severe bradycardia (heart rate in the 30s BPM) with pauses but no AVB.
Findings:
- The patient was diagnosed with sick sinus syndrome (SSS) without AVB, a rare cardiac manifestation of Lyme disease.
- The patient responded well to antibiotic therapy with doxycycline.
Implications:
- This case expands the spectrum of cardiac presentations of Lyme carditis beyond AVB.
- Clinicians should consider Lyme carditis in patients from endemic areas presenting with new-onset bradycardia, even without typical AVB.
- Early diagnosis and treatment are crucial for managing Lyme carditis and its neurological complications.
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