Complete AV block in Lyme carditis: an important differential diagnosis.
Lyme disease is a tick-borne spirochetal infection that may affect the heart. Cardiac manifestations include conduction disturbances and other pathologies of the heart. We report on a 37-year old male, who was admitted to the emergency department because of dizziness and generalized tiredness. Physical examination and the initial laboratory values revealed no abnormalities. The patient's electrocardiogram on admission revealed newly diagnosed bradycardia due to atrioventricular heart block. The ventricular heart rate was 35/min. The patient was admitted to the ICU. Lyme serology and Western blot were positive for Borrelia antibodies. After institution of antibiotic therapy with ceftriaxone, atrioventricular heart block resolved rapidly. We therefore have to assume that in this patient Lyme carditis was the cause of third-degree AV block.
Semmler
D
D
Medizinische Klinik, GPR-Klinikum, Rüsselsheim, Germany. semmd@gmx.de
Blank
R
R
Rupprecht
H- J
H
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D054537:Atrioventricular Block / Q000175:diagnosis* / Q000188:drug therapy*; D002443:Ceftriaxone / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone
N Engl J Med. 2002 May 30;346(22):1732-8
12037154
Z Kardiol. 2002 Dec;91(12):1053-60
12490995
Internist (Berl). 2001 Jun;42(6):901-4
11449636
Clin Res Cardiol. 2008 Oct;97(10):760-7
18516488
Clin Res Cardiol. 2008 Oct;97(10):787-90
18633566
Am Heart J. 1991 May;121(5):1558-60
2017995
Ann Intern Med. 1983 Dec;99(6):767-72
6316826
Clin Res Cardiol. 2008 Apr;97(4):280-3
18193372
J Infect Dis. 1993 Feb;167(2):392-400
8380611
Clin Res Cardiol. 2009 Dec;98(12):753-63
19756815
Clin Res Cardiol. 2010 Feb;99(2):129-31
19921297
Am J Med. 1995 Apr 24;98(4A):10S-12S; discussion 12S-14S
7726186
Eur Heart J. 1991 Aug;12 Suppl D:73-5
1915460
Clin Res Cardiol. 2009 Jan;98(1):66-70
18853095
Am J Cardiol. 1995 Jul 1;76(1):97-100
7793418
Klin Wochenschr. 1990 Apr 17;68(8):431-5
2348647
Lancet. 1998 Aug 15;352(9127):557-65
9716075
N Engl J Med. 2001 Jul 12;345(2):115-25
11450660
Clin Infect Dis. 2006 Nov 1;43(9):1089-134
17029130
Eur J Clin Microbiol Infect Dis. 1999 Oct;18(10):697-703
10584895
Ann Intern Med. 1989 Mar 1;110(5):339-45
2644885
Science. 1982 Jun 18;216(4552):1317-9
7043737
Scand J Infect Dis Suppl. 1991;77:81-4
1947815
Clin Res Cardiol. 2008 Sep;97(9):623-7
18677436
Am J Med. 1991 Apr;90(4):531-3
2012098