Lyme Carditis With Complete Heart Block Successfully Treated With Oral Doxycycline.

Area of Science:

• Infectious Diseases
• Cardiology
• Internal Medicine

Background:

• Lyme carditis is a serious complication of Lyme disease, characterized by high-grade atrioventricular block.
• Current guidelines advocate for hospitalization and intravenous antibiotics for Lyme carditis management.
• Early diagnosis and appropriate treatment are crucial for patient outcomes.

Purpose of the Study:

• To present a case of Lyme carditis with complete heart block.
• To investigate the efficacy of oral doxycycline in resolving Lyme carditis.
• To suggest oral doxycycline as a potential alternative treatment for Lyme carditis.

Main Methods:

• A case report of an active duty male diagnosed with Lyme disease and subsequent Lyme carditis.
• Initial misinterpretation of electrocardiogram (ECG) findings.
• Review of ECGs and cardiology consultation.
• Assessment of cardiac function through exercise stress testing.

Main Results:

• The patient presented with symptoms of Lyme disease and later developed exercise intolerance.
• Initial ECG was misinterpreted, but subsequent review revealed complete heart block.
• Complete heart block resolved following treatment with oral doxycycline.
• Exercise stress testing confirmed chronotropic competence post-treatment.

Conclusions:

• Lyme carditis can present with complete heart block.
• Oral doxycycline may be an effective alternative treatment for Lyme carditis.
• This case highlights the importance of accurate ECG interpretation and considering alternative treatment regimens.