Cardiac Magnetic Resonance Imaging in Lyme Carditis-A Case Series and Review of Literature

Matthew Kaczynski1, Suhani Desai1, Brian Osorio1

  • 1Division of Cardiology, Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.

Insights

Lyme carditis, a serious heart complication of Lyme disease, is challenging to diagnose. Cardiac magnetic resonance (CMR) shows promise for diagnosing this condition, as demonstrated in two case studies.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Lyme carditis is a rare but severe complication of early disseminated Lyme disease.
  • Diagnosis is difficult due to non-specific symptoms and limited diagnostic tools for cardiac involvement.
  • Cardiac magnetic resonance (CMR) is standard for cardiomyopathy but understudied in Lyme carditis.

Purpose of the Study:

  • To present cases of Lyme carditis diagnosed using CMR.
  • To review the current literature on CMR's utility in diagnosing Lyme carditis.
  • To highlight CMR as a potential diagnostic tool for Lyme carditis.

Main Methods:

  • Case report of two patients with CMR-proven Lyme carditis.
  • Comprehensive literature review on CMR use in Lyme carditis.
  • Analysis of diagnostic accuracy and findings in reported cases.

Main Results:

  • CMR imaging successfully identified cardiac involvement in both presented cases.
  • Literature review indicates CMR can reveal characteristic findings in Lyme carditis.
  • CMR offers a non-invasive method to assess cardiac function and inflammation.

Conclusions:

  • Cardiac magnetic resonance imaging is a valuable tool for diagnosing Lyme carditis.
  • Further research is warranted to establish CMR's role in Lyme carditis management.
  • CMR can aid in timely diagnosis and appropriate treatment of Lyme carditis.

Related Concept Videos

Imaging Studies for Cardiovascular System IV: CMRI01:21

Imaging Studies for Cardiovascular System IV: CMRI

Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
Myocarditis I: Introduction01:21

Myocarditis I: Introduction

Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...