Lyme carditis presenting as atrial fibrillation

Authors

Abir Zainal, Rochester Regional HealthFollow
Amir Hanafi, Rochester Regional HealthFollow
Ninad Nadkarni, Rochester Regional HealthFollow
Mahmood Mubasher, Rochester Regional HealthFollow
Deeraj Lingutla, Rochester Regional HealthFollow
Ryan Hoefen

Department

Medicine

Document Type

Article

Publication Title

BMJ Case Reports

Abstract

The incidence of Lyme disease in the USA is 8 per 100 000 cases and 95% of those occur in the Northeastern region. Cardiac involvement occurs in only 1% of untreated patients. We describe the case of a 46-year-old man who presented with chest pressure, dyspnoea, palpitations and syncope. He presented initially with atrial fibrillation with rapid ventricular response, a rare manifestation of Lyme carditis. In another hospital presentation, he had varying degrees of atrioventricular block including Mobitz I second-degree heart block. After appropriate antibiotic treatment, he made a full recovery and his ECG normalised. The authors aim to urge physicians treating patients in endemic areas to consider Lyme carditis in the workup for patients with atrial fibrillation and unexplained heart block, as the associated atrioventricular nodal complications may be fatal.

DOI

10.1136/bcr-2018-228975

Volume

12

Issue

4

Publication Date

4-1-2019

Recommended Citation

Zainal, A., Hanafi, A., Nadkarni, N., Mubasher, M., Lingutla, D., & Hoefen, R. (2019). Lyme carditis presenting as atrial fibrillation. BMJ Case Reports, 12 (4) https://doi.org/10.1136/bcr-2018-228975