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Common form of Lyme borreliosis carditis--complete heart block with syncope: report on 3 cases
Z Vasiljević1, R Dmitrović, Z Naumović
1University Institute for Cardiovascular Diseases, Faculty of Medicine, Belgrade, Yugoslavia.
Insights
Lyme borreliosis can cause severe heart block and syncope. Prompt diagnosis and treatment led to full recovery of heart rhythm in all affected patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Neurology
Background:
- Lyme borreliosis, a tick-borne illness, can present with diverse clinical manifestations.
- Cardiac involvement in Lyme borreliosis, particularly atrioventricular (AV) block, is a known but less common complication.
Observation:
- Three previously healthy patients presented with abrupt onset of syncope, indicative of severe Adams-Stokes attacks.
- Clinical diagnosis was supported by the presence of erythema migrans skin lesions and positive serologic tests for Borrelia burgdorferi.
- Patients did not recall a specific tick bite history.
Findings:
- All three patients were diagnosed with third-degree atrioventricular (AV) heart block secondary to Lyme borreliosis.
- Following diagnosis and treatment, all patients experienced a return to normal sinus rhythm with preserved AV conduction.
Implications:
- This case series highlights the importance of considering Lyme borreliosis in the differential diagnosis of sudden onset heart block and syncope, even without a clear tick bite history.
- Early recognition and appropriate management of Lyme borreliosis can lead to complete resolution of cardiac conduction abnormalities.
- Further research may elucidate the specific mechanisms by which Borrelia burgdorferi affects cardiac conduction pathways.
Abstract:
Third degree atrioventricular (AV) heart block with severe Adams-Stokes attacks in 3 patients with Lyme borreliosis is described. All patients had similar clinical manifestations: previously healthy, they experience syncope as an abrupt onset of the disease. Data on skin changes--erythema migrans--was subsequently obtained, although the patients did not recall being bitten by a tick. Diagnoses were based on clinical manifestations and on positive serologic test results to borrelia. Following AV block returned to sinus rhythm with normal AV conduction in all patients.