An Unusual Presentation of Lyme Carditis and Adenosine-Sensitive Atrioventricular Block

Introduction

Lyme carditis (LC) is a relatively rare manifestation of the early disseminated stage of LC. ^, The most frequent presentation of LC is atrioventricular (AV) block characterized by rapid fluctuations in the grade and that occurs in approximately 80-90% of patients. ^, Other possible clinical manifestations of LC are myocarditis, pericarditis, dilated cardiomyopathy, and heart failure. ^, The clinical course is usually mild, short-term, and in most cases completely reversible after adequate antibiotic treatment. Indeed, high-grade AV block associated with Lyme disease typically resolves within the first ten days of antibiotic therapy. The authors present a case of a young female diagnosed with early disseminated Lyme disease and cardiac manifestations, in whom AV conduction disturbances persisted after four weeks of appropriate antibiotic treatment and led to an alternative diagnosis.

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