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Published Date

25/05/2020

Fatal Lyme carditis presenting as fluctuating high-grade atrioventricular block

Journal

Canadian Medical Association Journal

Citation

192(21):E574-E577

DOI

10.1503/cmaj.191194. Epub 2020 May 24

Authors

Semproni M, Rusk R, Wuerz T

Abstract

KEY POINTS

Clinicians should be aware of the risk of Lyme carditis in patients presenting with atrioventricular (AV) block, especially those with a history of outdoor exposure in Lyme endemic areas, even if they do not endorse tick exposure or history of erythema migrans.

Urgent electrocardiography shoud be obtained and antibiotics started early if there is suspicion of Lyme carditis, without waiting for serologic confirmation.

In patients with suspected Lyme carditis, monitoring with telemetry for at least 24?48 hours should be considered and availability of transcutaneous pacing ensured in case of deterioration.

Clinicians should recognize the potential for rapid progression of AV nodal block and symptomatic bradycardia, as well as sudden cardiac death in patients with Lyme carditis.

URL

No

Review Needed?

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