All Posts Tagged With: "Lyme carditis"

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=21125053&retmode=ref&cmd=prlinks

Excerpt:

A 54-year-old American woman presented with an episode of syncope. This had
occurred against a background of several days of dizziness and palpitations.
Her medical history included Bell’s palsy, which had been diagnosed three
weeks earlier. On examination, she had a resting bradycardia of 31 beats per
minute and her electrocardiogram demonstrated third-degree atrioventricular
(AV) block.
She was referred to cardiology for consideration of permanent pacemaker
implantation. Given her facial nerve palsy and AV block, a diagnosis of Lyme
borreliosis was suspected. Within 48 hours of initiation of ceftriaxone, she
reverted to sinus rhythm, albeit with a marked first-degree AV block.
Subsequent serology confirmed the diagnosis. Reversible causes of complete
AV block should always be considered and appropriate therapy may avoid the
need for permanent pacemaker insertion.

Link: http://journals.lww.com/em-news/Fulltext/2005/11000/Lyme_Carditis__From_Asymptomatic_First_Degree.9.aspx

Excerpt:

A previously healthy 17-year-old girl was brought to our ED after a syncopal episode that occurred while she was standing in her kitchen earlier that evening. According to her mother, who was speaking to her at the time of the episode, she suddenly dropped to her knees and then lost consciousness for approximately 10 to 20 seconds. When she regained consciousness, she quickly returned to her baseline mental status, denying any confusion or lethargy. In fact, during our interview with the patient, she reported feeling great immediately after this event.

Her ECG showed an accelerated junctional rhythm with a rate of 120 beats per minute. Further history revealed that she had been seen by her pediatrician on the previous day for evaluation of a rash. She described the rash as it appeared that day as several erythematous patches approximately 5 cm to 6 cm in diameter that were located on her left forearm, abdomen, and thighs. She denied any previous skin conditions such as eczema or psoriasis, and could not recall any recent exposures to plants, ticks, new medications, or cleaning products. She was given a prescription for diphenhydramine, and aside from some general fatigue, was doing well up to the time of her syncopal event.

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20840915&retmode=ref&cmd=prlinks

Excerpt:

The tick bite transmitted Lyme disease is one of the most common
antropozoonosis, about 10 000 new infections are reported in
Hungary each year.
The progress and clinical presentation can vary, and carditis can
occur in later stages. A serologically verified Lyme disease
caused third degree atrioventricular block in young male
presenting with presyncope. Based on the tick-bites mentioned a
few weeks prior to hospital admission, Lyme carditis was
considered with the administration of antibiotics and monitor
observation.
Typical skin lesions were not recognized and laboratory findings
showed no pathology. An electrophysiological study recorded a
predominant supra-His atrioventricular block. Total regression of
conduction could be detected later and the serological tests
established an underlying Lyme disease. Currently no definite
treatment recommendation is available for the potentially
reversible Lyme carditis. The tick bite seemed to be the key on
our way to diagnosis; however, serological tests proved the
disease to be older than one year. A detailed medical history and
serological tests are essential in identifying the cause and
pacemaker implantation can be avoided. Orv. Hetil., 2010, 39,
1585-1590.

Excerpt:

A fatal case of Lyme carditis occurring in a Suffolk farmworker is reported. Post-mortem examination of the heart showed pericarditis, focal myocarditis and prominent endocardial and interstitial fibrosis. The additional finding of endodermal heterotopia (‘mesothelioma’) of the atrioventricular node raises the possibility that this could also be related to Lyme infection and account for the relatively frequent occurrence of atrioventricular block in this condition. Lyme disease should always be considered in a case of atrioventricular block, particularly in a young patient from a rural area. The heart block tends to improve and therefore only temporary pacing may be required.

Full article: http://www.amc.edu/amr/archives/200606/case1.html

Excerpt:

A 52-year-old male marathon runner with a past medical history significant for glaucoma presented to the emergency department with a two-week history of increasing fatigue after an episode of syncope.

He initially presented to his primary care doctor’s office complaining of flu like symptoms one week after running a marathon and three weeks prior to admission. He described fever, chills, night sweats, increasing fatigue and body aches. He was noted to be an avid runner who had finished within the top five to ten athletes in prior marathons. He stated that despite training intensely, he only finished in 50th place. During this visit, a chest x-ray was obtained which showed no evidence of pneumonia or other abnormalities. He was diagnosed with a minor viral upper respiratory tract infection and over the following week began to notice improvement of his symptoms.

He returned to the office two weeks after the initial visit with worsening fatigue and decreased exercise tolerance. He had become increasingly short of breath after running more than 2 milles. A serologic test for Lyme disease was performed to rule out Lyme carditis after an EKG showed first-degree heart block.

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20464556&retmode=ref&cmd=prlinks

Excerpt:

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 Cardiac manifestations 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.

Excerpt:

A 36year old male patient presented to emergency cardiology
department because of fatigability. ECG revealed high grade II
atrio-ventricular block and bradycardia of 31beats/min. An
erythema increasing in size to up to 7-8cm in diameter appeared a
month earlier and spontaneously resolved within 10days.
ELISA testing for antibodies against Borrelia burgdorferi IgM was
positive and IgG titer was 1:40. Intravenous ceftriaxone 2g qod,
and 0.5g metronidazole tid lead to regression of grade II block
to grade I block within 2days. Grade I block persisted for an
additional 10days. This is a relatively rare case of early
occurrence of Lyme carditis within one month of exposure as the
first sign of Lyme disease dissemination. Copyright (c) 2010.
Published by Elsevier Ireland Ltd.

Article:

A 36year old male patient presented to emergency cardiology
department because of fatigability. ECG revealed high grade II
atrio-ventricular block and bradycardia of 31beats/min. An
erythema increasing in size to up to 7-8cm in diameter appeared a
month earlier and spontaneously resolved within 10days.
ELISA testing for antibodies against Borrelia burgdorferi IgM was
positive and IgG titer was 1:40. Intravenous ceftriaxone 2g qod,
and 0.5g metronidazole tid lead to regression of grade II block
to grade I block within 2days. Grade I block persisted for an
additional 10days. This is a relatively rare case of early
occurrence of Lyme carditis within one month of exposure as the
first sign of Lyme disease dissemination. Copyright (c) 2010.
Published by Elsevier Ireland Ltd.

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20226549&retmode=ref&cmd=prlinks

Linda’s comments:  Lyme Carditis in children is not getting the attention it should be getting.  Makes me wonder how many of the athletes who drop dead in their sport isn’t suffering from Lyme Carditis and have been grossly mis-diagnosed??

NEW YORK (Reuters Health) May 01 – Manifestations of Lyme carditis in children can range from asymptomatic first-degree heart block to fulminant myocarditis, physicians at Harvard Medical School report in the May issue of Pediatrics. Data from their case series indicate that older age, arthralgia, and cardiopulmonary symptoms were independent predictors of carditis in pediatric patients with early disseminated Lyme disease. Continued

Lyme Disease, caused by the spirochete Borrellia burgdorferi, is the most common vector-borne disease in the United States. Clinically, it primarily affects the skin, joints, nervous system, and heart. Lyme carditis occurs in 4%-10% of adults with Lyme disease. Transient variable-level atrioventricular blocks, occurring in 77% of adults with Lyme carditis, are the most common cardiac manifestation. Up to 50% of Lyme carditis patients may develop complete heart block. The incidence of Lyme carditis in the pediatric population is not well established. We present a pediatric patient with a transient asymptomatic complete heart block resulting from Lyme carditis, an under-recognized complication of Lyme disease in the pediatric population. ^Continued