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Lyme Carditis With Complete Heart Block

Ashot Batikyan1, Hakob Harutyunyan2, Vahagn Tamazyan2

  • 1Department of Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center/North Central Bronx Hospital, Bronx, USA.

Cureus
|April 17, 2025
PubMed

Insights

Early recognition and treatment of Lyme carditis, a tick-borne illness, can prevent severe heart complications like third-degree AV block, potentially avoiding permanent pacemakers.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Tick-borne Illnesses

Background:

  • Lyme disease is a prevalent North American tick-borne infection.
  • Lyme carditis can cause significant cardiac complications, including atrioventricular block.

Observation:

  • A 42-year-old male presented with third-degree atrioventricular (AV) block following a tick bite and erythema migrans.
  • Symptoms included fatigue, palpitations, and dyspnea, with EKG confirming third-degree AV block.

Findings:

  • The patient received temporary transvenous pacing and intravenous ceftriaxone.
  • Significant improvement was observed within 48 hours, with resolution to first-degree AV block.
  • Treatment was transitioned to oral doxycycline for completion.

Implications:

  • This case highlights the importance of prompt diagnosis and management of Lyme carditis.
  • Early intervention can prevent severe cardiac events and the need for permanent pacemakers.
  • Awareness of Lyme carditis symptoms is crucial for timely treatment in endemic areas.

Keywords:
borrelia burgdorferi infectioncomplete atrioventricular blocklyme carditislyme's diseasethird degree atrioventricular block

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