Lyme Carditis Complicated by Polymorphic Ventricular Tachycardia and Cardiac Arrest: A Case Report

Area of Science:

• Infectious Diseases
• Cardiology
• Emergency Medicine

Background:

• Lyme disease, caused by *Borrelia burgdorferi*, is prevalent in the US.
• Lyme carditis typically presents as atrioventricular nodal blockade during early disseminated infection.
• Prompt antibiotic treatment usually resolves cardiac conduction issues.

Observation:

• A case report details a previously healthy male with syncope, annular rashes, and knee pain.
• The patient exhibited positive Lyme testing and pause-dependent polymorphic ventricular tachycardia, leading to cardiac arrest.
• This highlights a rare but severe presentation of Lyme carditis.

Findings:

• Lyme carditis, while usually manageable, can rarely progress to fatal cardiac arrest.
• The case underscores the potential for severe cardiac arrhythmias in Lyme disease.
• Diagnostic confirmation involved 2-tier Lyme testing.

Implications:

• Emergency physicians should consider Lyme carditis in undifferentiated syncope, especially with rash and joint pain.
• Risk stratification and established guidelines aid in managing suspected Lyme carditis.
• This case emphasizes the importance of recognizing atypical presentations of Lyme disease for timely intervention.