scholarly journals Lyme Carditis: An Interesting Trip to Third-Degree Heart Block and Back

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Maxwell Eyram Afari ◽  
Fady Marmoush ◽  
Mobeen Ur Rehman ◽  
Umama Gorsi ◽  
Joseph F. Yammine
Keyword(s):  
Lyme Disease ◽  
Heart Block ◽  
Complete Heart Block ◽  
Early Recognition ◽  
Erythema Migrans ◽  
Young Female ◽  
Cardiac Conduction ◽  
Lyme Carditis ◽  
Uncommon Presentation ◽  
Degree Heart Block

Carditis is an uncommon presentation of the early disseminated phase of Lyme disease. We present the case of a young female who presented with erythema migrans and was found to have first-degree heart block which progressed to complete heart block within hours. After receiving ceftriaxone, there was complete resolution of the heart block in sequential fashion. Our case illustrates the importance of early recognition and anticipation of progressive cardiac conduction abnormalities in patients presenting with Lyme disease.

scholarly journals Lyme Carditis in Hospitalized Children and Adults, a Case Series

2021 ◽  
Author(s):  
Richard V Shen ◽  
Carol A McCarthy ◽  
Robert P Smith
Keyword(s):  
Lyme Disease ◽  
Heart Block ◽  
Early Recognition ◽  
Erythema Migrans ◽  
Case Series ◽  
Outpatient Setting ◽  
Temporary Pacing ◽  
Lyme Carditis ◽  
Viral Illness ◽  
History Presentation

Abstract Background Lyme carditis is an uncommon manifestation of Lyme disease. This report compares Lyme carditis presentation, management, and outcomes in pediatric and adult populations. Methods Charts of pediatric and adult patients with heart block (PR >300ms) and positive Lyme serologies hospitalized in Portland, Maine between January 2010 and December 2018 were analyzed. Data on medical history, presentation, treatment, and outcomes are described. Results Ten children and 20 adults were admitted for Lyme carditis between June and October. Ninety percent were male, and 87% had no prior cardiac history. Seventeen had outpatient evaluation prior to admission. Of these, a minority (41%) had Lyme disease suspected in the outpatient setting, and fewer (12%) were initiated on Lyme disease treatment. The most common alternate diagnoses were viral illness and erythema multiforme. More children than adults had disseminated erythema migrans and fever. First-degree heart block was more prevalent in children, and Mobitz type 2 heart block was more prevalent in adults. Ten patients presented with syncope. Proportionately more adults needed temporary pacing. Children had shorter antibiotic durations compared to adults. Of the 30 cases, twenty-seven had improved heart block, while 3 adults required a pacemaker at discharge. Nine children and 14 adults were discharged with a PR 200-300ms. There was a single death in this series. Conclusion Cases tended to be younger males. Most patients had some heart block on discharge. Of patients evaluated as outpatients, Lyme disease was suspected in 41%. Improved early recognition and treatment of Lyme disease may decrease Lyme carditis.

scholarly journals 134. A Comparison of Lyme Carditis in Children and Adults, a Case Series

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S95-S95
Author(s):  
Richard V Shen ◽  
Carol A McCarthy ◽  
Robert P Smith
Keyword(s):  
Lyme Disease ◽  
Heart Block ◽  
Erythema Migrans ◽  
Case Series ◽  
Adult Patients ◽  
Male Predominance ◽  
Temporary Pacing ◽  
Lyme Carditis ◽  
Viral Illness ◽  
History Presentation

Abstract Background Lyme disease is a common entity in Maine, and Lyme carditis is an uncommon manifestation of this disease. This case series describes and compares the presentation, management, and outcomes of Lyme carditis in pediatric and adult populations. Methods Charts of pediatric and adult patients with heart block and positive Lyme serologies hospitalized in Portland, Maine between January 2010 and December 2018 were analyzed. Data on medical history, presentation, treatment, and outcomes are described. Results Ten children (range 7–17, mean 12.4 years) and 20 adults (range 22–81, mean 41.4 years) were admitted for Lyme carditis in the examined period. All cases presented between June and October. Twenty-seven (90%) were male, and 26 (87%) had no prior cardiac history. Of the adults, 1 (5%) reported using cocaine, 4 (20%) opioids, and 6 (30%) marijuana. Seventeen (57%) had outpatient evaluation prior to admission. Ten patients (59%) were not recognized as having Lyme disease. One case suspected to have Lyme was not initially treated with doxycycline. The most common alternative diagnoses were a viral illness and erythema multiforme. No coinfections were noted. Proportionately more children than adults had disseminated erythema migrans (40% vs. 20%) and fever (60% vs. 35%). First degree heart block was more prevalent in children (40%), and Mobitz type 2 heart block was more prevalent in adults (55%). Ten patients (30%) presented with syncope. More adults than children needed temporary pacing, 9 (45%) vs. 2 (20%). Children had shorter antibiotic durations compared with adults (mean 19.8 days vs. 23.6 days) Twenty-seven (90%) had improved heart block. Three adult patients (10%) required a pacemaker following hospitalization. Nine (90%) children and 14 (70%) adults were discharged with a PR 200-300ms. There was a single death in this series, which occurred after discharge to another state. Conclusion Cases tended to be in younger patients with male predominance. Most patients still had some degree of heart block on discharge. The majority of patients were evaluated prior to hospitalization but Lyme disease was suspected in only 41%. Improved recognition of early Lyme disease and more prompt treatment may lead to decreased complications of Lyme carditis. Disclosures All authors: No reported disclosures.

scholarly journals Lyme carditis presenting as atrial fibrillation

2019 ◽  
Vol 12 (4) ◽  
pp. e228975 ◽  
Author(s):  
Abir Zainal ◽  
Amir Hanafi ◽  
Ninad Nadkarni ◽  
Mahmood Mubasher ◽  
Deeraj Lingutla ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Lyme Disease ◽  
Antibiotic Treatment ◽  
Heart Block ◽  
Cardiac Involvement ◽  
Lyme Carditis ◽  
Rare Manifestation ◽  
The Usa ◽  
Ventricular Response ◽  
Degree Heart Block

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.

Lyme Carditis With Complete Heart Block Successfully Treated With Oral Doxycycline

2021 ◽  
Author(s):  
Michael Burns ◽  
Paul Robben ◽  
Ramesh Venkataraman
Keyword(s):  
Lyme Disease ◽  
Heart Block ◽  
Complete Heart Block ◽  
Subsequent Development ◽  
Exercise Stress ◽  
Exercise Intolerance ◽  
Cardiac Monitoring ◽  
Oral Doxycycline ◽  
Lyme Carditis ◽  
Organ Systems

ABSTRACT Lyme disease is a vector-borne infection that can affect multiple different organ systems. Lyme carditis represents one of these sequelae and is defined by acute onset of high-grade atrioventricular block in the presence of laboratory-confirmed infection. Current guidelines recommend patients with Lyme carditis be admitted for close cardiac monitoring and intravenous antibiotics therapy. Our case illustrates an active duty male who was initially diagnosed with Lyme disease after initially reporting symptoms including headache, fever, eye pain, and rash, with subsequent development of exercise intolerance 6 weeks later. An electrocardiogram (ECG) obtained at that time was misinterpreted as first-degree heart block, and he was initiated on oral doxycycline therapy and referred to cardiology. On follow-up to cardiology clinic, the prior ECG was reviewed and interpreted as complete heart block. A repeat ECG showed resolution of the heart block, and exercise stress testing showed chronotropic competence. This case illustrates the resolution of complete heart block in Lyme carditis with oral doxycycline, suggesting this antibiotic as a possible alternative treatment agent.

Complete Heart Block after open Heart Surgery in Children with Congenital Cardiac Diseases Feasibility of more waiting time before PPM administration

2021 ◽  
Vol 4 (11) ◽  
pp. 01-06
Author(s):  
Akbar Molaei
Keyword(s):  
Heart Block ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Complete Heart Block ◽  
Heart Defects ◽  
Open Heart Surgery ◽  
Cardiac Conduction ◽  
Cardiac Diseases ◽  
Open Heart ◽  
Cardiac Disorders

Introduction: Congenital cardiac disorders are the most prevalent congenital disorders which require interventional or surgical treatments. The most common causes of complete heart block (CHB) are degeneration of cardiac conduction system, acute myocardial infarction and congenital cardiac disorders. CHB after congenital heart surgery is of paramount importance which causes post-operation death and heart failure. Application of a pacemaker is a standard treatment for CHB. The purpose of this paper is to study the frequency of early postoperative CHB in patients with congenital cardiac diseases and also the need for temporary (TPM) and permanent (PPM) pacemakers. Materials and methods: This descriptive-analytical and cross-sectional study was conducted on children with congenital heart defects who had undergone open-heart surgery in Tabriz’s Shahid Madani Hospital from 2011 to 2016. Patients with early postoperative CHB were included in the study. Those who had improved on their own and those who needed TPM and PPM were identified and at the end, the frequency of CHB and the need for TPM and PPM were assessed. Results: Of the 2100 operated patients, 109 patients developed early postoperative heart block. The frequency of early CHB after open heart surgery was 5.19%. Of the 109 patients, 69 patients (63.3%) with early postoperative CHB needed TPM, 9 patients needed PPM and 22 patients improved without pacemaker. Conclusion: The prevalence of early CHB in patients operated for congenital cardiac diseases was 5.19%. The need for TPM was high and most of the patients had improved cardiac rhythm with no need for PPM or TPM.

Relation of elevated serum uric acid levels to first-degree heart block and other cardiac conduction defects in hospitalized patients with type 2 diabetes

2017 ◽  
Vol 31 (12) ◽  
pp. 1691-1697 ◽  
Author(s):  
Alessandro Mantovani ◽  
Riccardo Rigolon ◽  
Isabella Pichiri ◽  
Giovanni Morani ◽  
Stefano Bonapace ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Heart Block ◽  
Elevated Serum ◽  
Hospitalized Patients ◽  
Cardiac Conduction ◽  
Degree Heart Block

scholarly journals Fetal heart rate tracing interpretation in cases of fetal heart block: A case series

2021 ◽  
Author(s):  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Leuwan ◽  
Kuntharee Traisrisilp ◽  
Phudit Jatavan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Vaginal Delivery ◽  
Fetal Heart Rate ◽  
Heart Block ◽  
Fetal Heart ◽  
Complete Heart Block ◽  
Case Series ◽  
Fetal Surveillance ◽  
Degree Heart Block ◽  
Second Degree

Simple assessment of FHR baseline variability can differentiate second degree heart block (SHB) from complete heart block (CHB). In cases of SHB, antepartum NST can be reliably used for fetal surveillance. Intrapartum assessment of FHR variability as well as accelerations is useful to select cases for safe vaginal delivery

Arrhythmias and Stokes-Adams Attacks in Acute Rheumatic Fever

PEDIATRICS ◽  
1978 ◽  
Vol 61 (4) ◽  
pp. 599-603
Author(s):  
Cora C. Lenox ◽  
James R. Zuberbuhler ◽  
Sang C. Park ◽  
William H. Neches ◽  
Robert A. Mathews ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Atrioventricular Block ◽  
Heart Block ◽  
Continuous Monitoring ◽  
Acute Rheumatic Fever ◽  
Complete Heart Block ◽  
Temporary Pacing ◽  
Early Signs ◽  
Degree Heart Block

In spite of general complacency about first-degree heart block in acute rheumatic fever, abnormal conduction with dysrhythmias, occasional complete heart block, and, rarely, Stokes-Adams attacks are important early signs of acute rheumatic fever and may precede other signs. Every person with episodic fainting is entitled to an ECG, and frequent ECGs are imperative in any case of rheumatic fever with signs of arrhythmias. Changing atrioventricular block necessitates continuous monitoring for dysrhythmias. A 13-year-old boy who appeared with Stokes-Adams attacks secondary to acute rheumatic fever was successfully treated by temporary pacing.

CONGENITAL HEART BLOCK DUE TO A LESION IN THE CONDUCTION SYSTEM

PEDIATRICS ◽  
1970 ◽  
Vol 45 (4) ◽  
pp. 640-650
Author(s):  
Cirilo Sotelo-Avila ◽  
Harvey S. Rosenberg ◽  
Dan G. McNamara
Keyword(s):  
Heart Block ◽  
Congenital Heart ◽  
Complete Heart Block ◽  
Fibrous Tissue ◽  
Postmortem Examination ◽  
Conduction System ◽  
Cardiac Conduction ◽  
Fibrous Body ◽  
Congenital Complete Heart Block ◽  
Bundle Of His

The cardiac conduction system of an infant with congenital complete heart block was studied at postmortem examination by subserial sections of the interatrial and interventricular septa. A localized area of necrosis in the central fibrous body interrupted the penetrating portion of the bundle of His. The cardiac structure was intact, with no abnormality other than the lesions in the fibrous tissue. The lesion is interpreted as the result of an acquired inflammation late in intrauterine life, with damage localized to the cardiac central fibrous body.

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