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[Cardiac manifestations of Lyme disease. Apropos of 2 cases]
Insights
Lyme disease, characterized by migratory erythema and cardiac issues like atrio-ventricular block, is rarely reported in France. Early recognition and treatment with antibiotics are crucial for managing this tick-borne illness.
Area of Science:
- Cardiology
- Infectious Diseases
- Dermatology
Background:
- Lyme disease is infrequently documented in French medical literature.
- This tick-borne illness presents with diverse manifestations, including dermatological, neurological, joint, and cardiac symptoms.
Observation:
- Two cases of Lyme disease presenting with acute symptomatic atrio-ventricular block were observed in a Cardiology Department.
- The initial symptom is typically migratory erythema, a key diagnostic marker.
Findings:
- Cardiac involvement in Lyme disease commonly manifests as atrio-ventricular block, which is usually transient.
- Diagnosis relies on clinical presentation and exclusion of other infectious agents, especially with the identification of Ixodes dammini.
- Penicillin and tetracycline are effective treatments during the early skin lesion stage.
Implications:
- Recognizing Lyme disease is vital due to its potential cardiac complications, such as atrio-ventricular block.
- Prompt diagnosis and treatment can prevent prolonged or severe cardiac involvement.
Abstract:
Lyme disease, a well-known entity in the United States, has featured only rarely in the French literature. We report two cases from the Cardiology Department with acute symptomatic atrio-ventricular block. The illness begins with migratory chronic erythema, which is the best marker of the condition. This is followed by neurological, joint and cardiac manifestations. Cardiac involvement consists essentially in A-V block of varying severity, which rapidly regresses. Until the recent discovery of the arthropod vector responsible (Ixodes dammini), the diagnosis was clinical and was confirmed by negative serological results for the other infectious agents. Penicillin and tetracycline are effective at the skin lesion stage. It is important to recognise this condition since there is no case of complete A-V block lasting longer than 2 weeks.