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Lyme Carditis and Inflammation-Driven Plaque Erosion Presenting as Sudden Cardiac Arrest
Marco Kaldas1,2, Moneal Shah2, Diana Pashaieva2
1Cardiovascular Magnetic Resonance Imaging Center, Department of Cardiology, Allegheny General Hospital, Pittsburgh, Pennsylvania.
Texas Heart Institute Journal
|August 6, 2025
Summary
Lyme carditis, a rare complication of Borrelia burgdorferi infection, can trigger ventricular tachycardia and acute coronary syndrome. This case shows the overlap of these conditions, leading to cardiac arrest and recovery with advanced care.
Area of Science:
- Cardiology
- Infectious Diseases
- Immunology
Background:
- Lyme carditis is a rare cardiac manifestation of Borrelia burgdorferi infection, typically causing conduction abnormalities.
- Malignant arrhythmias are an infrequent complication of Lyme carditis.
- Inflammatory acute coronary syndrome (ACS) involves immune-mediated plaque erosion, distinct from typical plaque rupture.
Observation:
- A previously healthy male patient presented with cardiac arrest due to ventricular tachycardia.
- Diagnostic imaging revealed myocardial inflammation and coronary plaque erosion, not rupture.
- The patient had confirmed Lyme disease.
Findings:
- The case demonstrates a rare overlap between Lyme carditis and inflammatory acute coronary syndrome.
- Ventricular tachycardia in this context was associated with myocardial inflammation and coronary plaque erosion.
- Multidisciplinary care and advanced diagnostics were crucial for management.
Implications:
- This case expands the understanding of potential cardiac complications in Lyme disease.
- It highlights the importance of considering infectious etiologies in patients with ACS and arrhythmias.
- Early recognition and comprehensive management can lead to favorable cardiac recovery.
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