[Transient complete AV block as a sequela of Borrelia myocarditis].
A 49-year-old man suddenly developed dyspnoea, sweating, fever (up to 38.5 degrees C), vertigo and angina. After emergency admittance to hospital the ECG showed 3 degrees A-V block, requiring temporary pacemaker insertion. The patient reported that a month before he had been bitten, probably by a tick. Serological tests demonstrated a recent Borrelia infection (rise of IgG antibody titre to 1:2048, IgM antibody titre to 1:128). Coronary angiography excluded any haemodynamically significant coronary heart disease as a cause of the conduction disorder. Myocardial biopsy showed changes pointing to a past myocarditis. This suggested Borrelia infection as the cause of the complete A-V block. Under treatment with broad-spectrum antibiotics for 15 days the fever subsided and the ECG became normal. Shortly before discharge, an elevated pulmonary wedge pressure on 150 W exercise indicated persistence of mild left-ventricular failure.
Kruse
K M
KM
Medizinische Klinik, St.-Bonifatius-Hospital, Lingen, Ems.
Gust
R
R
Grosse-Heitmeyer
W
W
D000907:Antibodies, Bacterial / Q000097:blood; D015748:Borrelia burgdorferi Group / Q000276:immunology; D006328:Cardiac Catheterization; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D006327:Heart Block / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D010138:Pacemaker, Artificial
D000907:Antibodies, Bacterial
Passagere komplette AV-Blockierung als Folge einer Borrelienmyokarditis.