Studija slučaja
Association of Lyme Disease and Erythema Migrans with Atrioventricular Block
Andrej Došen
; Department of Cardiology, General Hospital Karlovac, Croatia
Ivana Crnojević
; Department of Cardiology, General Hospital Karlovac, Croatia
Davor Horvat
; Department of Cardiology, General Hospital Karlovac, Croatia
*
* Dopisni autor.
Sažetak
The aim of this case report is to present a patient with Lyme carditis and
erythema migrans complicated with third-degree atrioventricular (AV) block and
the need for pacemaker implantation. A 20-year-old patient comes to the hospital
because of syncope. A few days earlier, he had chest pains with an irregular heartbeat.
Upon arrival, the heart rate is 30 beats per minute. The electrocardiogram (ECG)
shows AV block of the third degree with asystolic pauses. In laboratory findings, leukocytosis
(20x109) and C-reactive protein (10.8 mg/L). A transcutaneous temporary
external pacemaker was placed. Anamnestic information is obtained about a tick
bite and migrating erythema at the site of the bite one month before arrival at the
hospital. Enzyme immunoassay was positive for Borrelia burgdorferi. Ceftriaxone is
introduced into the treatment. Despite therapy, the patient has persistent symptomatic
AV block of the third degree with presyncope and syncope, which is why a permanent
two-chamber pacemaker is implanted. He was discharged from the hospital
in a cardiac stable condition. At the follow-up after one year, he was symptom-free,
there was no AV block in the ECG, and 0.1% ventricular stimulation was recorded in
the pacemaker’s memory. We conclude that third-degree AV block caused by a tick
bite, complicated by Borrelia burgdorferi infection with erythema migrans and carditis,
although in most cases it passes spontaneously, sometimes, if presyncope and
syncope are present, along with temporary electrostimulation of the heart, it requires
permanent electrostimulation of the heart
Ključne riječi
syncope; Borrelia burgdorferi; erythema migrans; carditis; electrostimulation of the heart
Hrčak ID:
346951
URI
Datum izdavanja:
26.2.2025.
Posjeta: 0 *