Dernedde S, Piper C, Kühl U, Kandolf R, Mellwig K P, Schmidt H K, Horstkotte D
Kardiologische Klinik, Herzzentrum Nordrhein-Westfalen Ruhr-Universität Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany.
Z Kardiol. 2002 Dec;91(12):1053-60. doi: 10.1007/s00392-002-0873-4.
An acute Lyme carditis affects about 0.3-4% of patients with Lyme borreliosis. The acute period of the disease may be associated with critical atrioventricular conduction abnormalities (complete heart block), supraventricular and ventricular arrhythmias as well a left ventricular failure. Normally, Lyme carditis is completely reversible. Therefore the prognosis largely depends on the management of the acute complications and early antibiotic therapy. Even if the symptoms are spontaneously reversible, antibiotic therapy should be applied to prevent a chronic cardiomyopathy and other manifestations of Lyme borreliosis. We report on a 47-year old patient with acute ECG changes initially suggesting an acute coronary syndrome. However, case history and the erythema migrans indicated an acute Lyme carditis which was confirmed serologically and by myocardial biopsy later.
急性莱姆病性心肌炎影响约0.3%-4%的莱姆病螺旋体病患者。疾病急性期可能伴有严重的房室传导异常（完全性心脏传导阻滞）、室上性和室性心律失常以及左心室衰竭。通常，莱姆病性心肌炎是完全可逆的。因此，预后很大程度上取决于急性并发症的处理和早期抗生素治疗。即使症状可自发逆转，也应应用抗生素治疗以预防慢性心肌病和莱姆病螺旋体病的其他表现。我们报告一名47岁患者，其急性心电图改变最初提示急性冠状动脉综合征。然而，病史和游走性红斑提示为急性莱姆病性心肌炎，随后经血清学检查和心肌活检得以证实。
