Lyme Carditis: Cardiac Abnormalities of Lyme Disease

Abstract

We studied 20 patients, mostly young adult men, with cardiac involvement of Lyme disease. The commonest abnormality (18 patients) was fluctuating degrees of atrioventricular block; eight of them developed complete heart block. Thirteen patients had evidence of more diffuse cardiac involvement: electrocardiographic changes compatible with acute myopericarditis (11 patients), radionuclide evidence of mild left ventricular dysfunction (five of 12 patients tested), or frank cardiomegaly (one patient). Heart involvement was usually preceded by erythema chronicum migrans and sometimes accompanied by meningoencephalitis, facial palsy, arthritis, elevated serum IgM levels, or cryoglobulins containing IgM. The duration of cardiac involvement was usually brief (3 days to 6 weeks). The clinical picture in these patients has similarities to acute rheumatic fever; but in Lyme disease, complete heart block may be commoner, myopericardial involvement tends to be milder, and valves seem not to be affected.

The Prevalence and Incidence of Clinical and Asymptomatic Lyme Borreliosis in a Population at Risk

“…Only 1 (2.2%) developed clinical Lyme borreliosis, Among all participants, the 6-month incidence of clinical Lyme borreliosis was 0.8% (6/755) but was much higher (8.1%) for asymptomatic seroconversion (45/558). In conclusion, positive Lyme serology was common in Swiss orienteers, but clinical disease occurred infrequently.Lyme disease, now often called Lyme borreliosis (LB), may affect the skin, heart, joints, and nervous system [1][2][3][4][5][6]. Neurologic, cardiologic, and rheumatologic manifestations such as meningoencephalitis, neuropathy, atrioventricular nodal block, myocarditis, and arthritis may follow in a few weeks to months after erythema migrans (EM).…”

“…Lyme disease, now often called Lyme borreliosis (LB), may affect the skin, heart, joints, and nervous system [1][2][3][4][5][6]. Neurologic, cardiologic, and rheumatologic manifestations such as meningoencephalitis, neuropathy, atrioventricular nodal block, myocarditis, and arthritis may follow in a few weeks to months after erythema migrans (EM).…”

Rapid complete atrioventricular heart block reversal due to Lyme carditis

“…LC was first described in 1980 [4], and can present in up to 10% of patients who encounter Lyme disease, especially if not appropriately treated [5]. In this report, we presented a case of LC with complete AV block that quickly reversed to regular sinus rhythm after the prompt initiation of antibiotic.…”

Therapy of Lyme Disease

“…presenting syncope, dyspnea, or chest pain) and/or subjects with secondor third-degree atrioventricular block or first-degree heart block with PR interval prolonged to 300 milliseconds, the hospitalization with continuous monitoring is advised [33]. The management options for treating myopericarditis and atrioventricular heart blocks include both oral and parenteral antibiotic therapy for 14 days (range 10-28 days) [11].…”