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Lyme carditis

Basil Ahmad Mahmood1, Øyvind Jervan2, Nezar Hikmat Raouf1

  • 1Hjertemedisinsk avdeling, Sykehuset Østfold, Kalnes.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|March 27, 2026
PubMed
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Lyme carditis, a heart complication of Lyme disease, can cause heart block. Prompt diagnosis and antibiotic treatment, like ceftriaxone, lead to full recovery, avoiding pacemakers.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Lyme carditis is a rare complication of Lyme disease, usually appearing 1-2 months post-infection.
  • Atrioventricular (AV) node involvement, causing conduction disturbances, is the most frequent clinical finding.

Purpose of the Study:

  • To present a case of Lyme carditis manifesting as atrioventricular block.
  • To highlight the importance of considering Lyme carditis in young patients with new-onset conduction disorders.

Main Methods:

  • A case report of a young woman presenting with palpitations and atrioventricular block.
  • Diagnostic workup included ECG, Borrelia serology, and exclusion of other causes of conduction disturbance.
  • Treatment involved a 21-day course of intravenous ceftriaxone.

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Main Results:

  • The patient presented with significant atrioventricular block (PR interval 380 ms) following a tick bite.
  • Borrelia serology was positive for Lyme disease.
  • Following treatment, the patient's ECG normalized, showing complete recovery.

Conclusions:

  • Lyme carditis should be suspected in patients, especially younger ones without prior cardiac history, presenting with conduction abnormalities.
  • Early diagnosis and treatment with antibiotics can prevent long-term complications such as permanent pacemaker implantation.
  • This case underscores the treatable nature and generally favorable prognosis of Lyme carditis.