Related Experiment Videos
Lyme carditis
Basil Ahmad Mahmood1, Øyvind Jervan2, Nezar Hikmat Raouf1
1Hjertemedisinsk avdeling, Sykehuset Østfold, Kalnes.
Insights
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.
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.
Background:
Lyme carditis is a rare manifestation of systemic Lyme disease, typically occurring one to two months after infection. The most common feature is conduction system disturbance, often involving the atrioventricular (AV) node.
Case Presentation:
A young woman was admitted to the emergency department after experiencing palpitations. She was haemodynamically stable and had no respiratory distress. An ECG revealed an atrioventricular block with a PR interval of 380 ms. Her medical history included a recent tick bite. Potential causes of conduction disturbances were ruled out and blood cultures were negative, while Borrelia serology showed positive IgG and borderline IgM. The patient received intravenous ceftriaxone for 21 days. Follow-up ECG revealed no abnormalities.
Conclusion:
Lyme carditis should be considered in conduction disorders, particularly in younger patients without a cardiovascular history. The condition generally has a good prognosis, and early recognition and appropriate treatment can prevent unnecessary pacemaker implantation.