Lyme disease presenting as heart block

Lyme disease is now recognized as an infectious process capable of involving multiple organs including the cardiovascular system. We recently treated a boy whose complaints on admission related only to symptomatic heart block that was severe enough to require transvenous pacing. This boy was subsequently determined to have had Lyme Disease after his medical testing was reevaluated for possible tick exposure. In rare instances symptomatic heart block may be the sole presenting complaint of Lyme Disease in children.