Lyme Carditis in Clinical Practice

 Nadiya Yarema¹, Kateryna Myndziv², Volodymyr Dzhyvak³

 

¹I. Horbachevsky Ternopil National Medical University, Department of Internal Medicine No.1, Ternopil, Ukraine
²I. Horbachevsky Ternopil National Medical University, Department of Physical Therapy,
 Occupational Therapy and Physical Education, Ternopil, Ukraine
³I. Horbachevsky Ternopil National Medical University,
Department of Children’s Diseases and Pediatric Surgery, Ternopil, Ukraine

 

SUMMARY

 

Introduction. Lyme disease is an infectious disease transmitted by the Ixodes ticks and is manifested by damaging various organs and systems (most often - migrating erythema, damage to the nervous system, musculoskeletal system, heart, liver and eyes). According to various authors, heart damage in Lyme borreliosis ranges from 4% to 10% and is an understudied pathology.

Case report. The article describes a clinical case of infectious myocarditis associated with Lyme disease in a 51-year-old patient. The course of the disease and the results of treatment of the patient were analyzed. The severe rhythm and conduction disorders were revealed: antrioventricular (AV) block of the first degree, transient AV block of the II degree (Mobitz 2) and III degree, polytopic extrasystoles. Due to timely diagnosis, including serological, prescribed etiotropic antibacterial treatment, the patient achieved a significant improvement in both clinical condition and positive serological and electrocardiogram (ECG) dynamics with improved AV conduction.

Conclusions. The most frequent ECG changes in Lyme carditis (LC) are conduction disorders with the development of blockades of various stages. For patients with myocarditis, which is accompanied by complex arrhythmias, and conduction disorders estimated as intermediate and high risk by Suspicious Index in Lyme Carditis (SILC) scale, serological examination should be recommended in order to verify the borreliosis etiology of myocarditis. In this particular case, early diagnostics and prescribed etiotropic treatment, in addition to treatment of heart failure, contributed to a significant improvement in both the clinical condition and positive serological and ECG dynamics.

 

Keywords: myocarditis, Lyme carditis, AV block, diagnostics, treatment

 

 Corresponding author:
Dzhyvak Volodymyr
e-mail: djyvak@tdmu.edu.ua