Related Experiment Videos
Cardiac manifestations of Lyme disease: a review
K S Nagi1, R Joshi, R K Thakur
1Arrhythmia Service, University Hospital, London, Ontario.
Insights
Cardiac Lyme disease, a tick-borne illness, affects up to 8% of patients, primarily causing early-phase conduction disturbances and myopericarditis. Most patients experience full recovery, though some may develop late complications.
Area of Science:
- Infectious Diseases
- Cardiology
- Tick-borne Illnesses
Background:
- Lyme disease is the most common North American vector-borne illness.
- Cardiac involvement, known as Lyme carditis, can occur in a subset of patients.
Purpose of the Study:
- To detail the clinical characteristics of cardiac manifestations in Lyme disease.
- To review the literature on Lyme carditis.
Main Methods:
- Systematic review of English-language clinical literature.
- MEDLINE database search from 1975 to 1995.
- Inclusion of studies on diagnosis, clinical features, treatment, and outcomes.
Main Results:
- Cardiac complications affect up to 8% of Lyme disease patients.
- Manifestations typically appear early (median 21 days post-erythema migrans).
- Common cardiac issues include atrioventricular block, myopericarditis, conduction disturbances, and heart failure; 90% achieve full recovery.
Conclusions:
- Lyme disease, caused by Borrelia burgdorferi, can lead to cardiac complications.
- These complications, including conduction issues and myopericarditis, generally occur early in the disease course.
Objective:
To describe the clinical features of cardiac manifestations of Lyme disease, the most common vector-borne illness in North America, which occasionally results in cardiac involvement.
Data Sources:
A review of the English-language clinical literature pertaining to Lyme disease and Lyme carditis indexed in MEDLINE from 1975 to 1995.
Data Extraction:
Studies describing diagnosis, clinical features, treatment or outcome were reviewed.
Data Synthesis:
Cardiac complications of Lyme disease may occur in up to 8% of patients. Cardiac manifestations occur in the early phase of the illness, at a median of 21 days from the onset of erythema migrans. Manifestations of Lyme carditis include atrioventricular block, myopericarditis, intraventricular conduction disturbances, bundle branch block and congestive heart failure. Temporary cardiac pacing may be required in up to a third of cases and complete recovery occurs in most (greater than 90%) patients. The overall prognosis of Lyme carditis is very good, although recovery may be delayed and late complications such as dilated cardiomyopathy may occur.
Conclusion:
Lyme disease is a tick-borne spirochetal infection caused by Borrelia burgdorferi. Cardiac complications of Lyme disease generally occur in the early phase and include conduction system disturbances, myopericarditis and congestive heart failure.