open access

Vol 65, No 5 (2007)
Other
Published online: 2007-06-01
Submitted: 2012-12-28
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Case reports
Complete heart block and Lyme disease: report of two different cases and literature review

Waldemar Elikowski, Małgorzata Małek, Jan Flieger, Artur Baszko, Arkadiusz Fagiewicz, Dariusz Wróblewski
Kardiol Pol 2007;65(5):565-570.

open access

Vol 65, No 5 (2007)
Other
Published online: 2007-06-01
Submitted: 2012-12-28

Abstract

The most typical manifestation of cardiac involvement in Lyme disease (LD) is a high grade and usually fluctuating heart block, which is generally reversible, even self-limiting. Two cases of LD with a different course of complete heart block (CHB) are described. In a 43-year-old man admitted due to episodes of syncope, the diagnosis of LD was delayed – after pacemaker implantation – when he developed joint and neurological symptoms. Following ceftriaxone treatment atrioventricular conduction returned to normal. In the second case of a 26-year-old woman, presenting on admission with fatigue and flu-like symptoms, ECG showed CHB with a stable escape rhythm of about 52/min. Unlike the first case, she could recall neither a tick bite nor skin rash, but epidemiological history and serologic test results were indicative of LD. In this case, antibiotic therapy did not influence atrioventricular block, which was well tolerated. This suggested the coexistence of borreliosis and previously unrecognised congenital CHB.

Abstract

The most typical manifestation of cardiac involvement in Lyme disease (LD) is a high grade and usually fluctuating heart block, which is generally reversible, even self-limiting. Two cases of LD with a different course of complete heart block (CHB) are described. In a 43-year-old man admitted due to episodes of syncope, the diagnosis of LD was delayed – after pacemaker implantation – when he developed joint and neurological symptoms. Following ceftriaxone treatment atrioventricular conduction returned to normal. In the second case of a 26-year-old woman, presenting on admission with fatigue and flu-like symptoms, ECG showed CHB with a stable escape rhythm of about 52/min. Unlike the first case, she could recall neither a tick bite nor skin rash, but epidemiological history and serologic test results were indicative of LD. In this case, antibiotic therapy did not influence atrioventricular block, which was well tolerated. This suggested the coexistence of borreliosis and previously unrecognised congenital CHB.
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Keywords

Lyme disease; borreliosis; complete heart block; Lyme carditis

About this article
Title

Case reports
Complete heart block and Lyme disease: report of two different cases and literature review

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 5 (2007)

Pages

565-570

Published online

2007-06-01

Bibliographic record

Kardiol Pol 2007;65(5):565-570.

Keywords

Lyme disease
borreliosis
complete heart block
Lyme carditis

Authors

Waldemar Elikowski
Małgorzata Małek
Jan Flieger
Artur Baszko
Arkadiusz Fagiewicz
Dariusz Wróblewski

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