Lyme Carditis Presenting With Complete Heart Block and Wide Complex Escape Rhythm
Jordan M Zaid1, Justin M Lingel2, Eitan Scheinthal1
1Department of Internal Medicine, Cooper University Hospital, Camden, New Jersey.
Texas Heart Institute Journal
|October 31, 2022
Insights
Newly diagnosed Lyme disease can cause complete heart block. Prompt antibiotic treatment rapidly resolved this unusual cardiac complication in a young woman.
Area of Science:
- Cardiology
- Infectious Diseases
- Electrophysiology
Background:
- Lyme disease, a tick-borne illness, can affect multiple organ systems.
- Cardiac involvement, known as Lyme carditis, can range from mild conduction abnormalities to complete heart block.
- Unusual electrocardiographic presentations of Lyme carditis warrant detailed case reporting.
Observation:
- A 19-year-old woman presented with newly diagnosed Lyme disease.
- She exhibited complete heart block with a right bundle branch block morphology escape rhythm.
- This specific electrocardiographic pattern is an uncommon manifestation of Lyme carditis.
Findings:
- Antibiotic therapy was initiated for the Lyme disease diagnosis.
- The patient's complete heart block and associated dysrhythmia resolved completely within 24 hours of treatment.
- This rapid resolution suggests a direct and reversible effect of antibiotic treatment on the cardiac manifestations.
Implications:
- This case underscores the importance of considering Lyme disease in the differential diagnosis of heart block, especially in endemic areas.
- It highlights an unusual, yet treatable, electrocardiographic manifestation of Lyme carditis.
- Early diagnosis and prompt antibiotic treatment are crucial for managing cardiac complications of Lyme disease.
Abstract:
A 19-year-old woman with newly diagnosed Lyme disease presented with complete heart block and an accompanying escape rhythm with a right bundle branch block morphology. With antibiotics, her dysrhythmia resolved completely within 24 hours of presentation. This case highlights an unusual electrocardiographic manifestation of Lyme carditis.
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