Cary N R, Fox B, Wright D J, Cutler S J, Shapiro L M, Grace A A
Department of Histopathology, Charing Cross and Westminster School, London, UK.
Postgrad Med J. 1990 Feb;66(772):134-6. doi: 10.1136/pgmj.66.772.134.
A fatal case of Lyme carditis occurring in a Suffolk farmworker is reported. Post-mortem examination of the heart showed pericarditis, focal myocarditis and prominent endocardial and interstitial fibrosis. The additional finding of endodermal heterotopia ('mesothelioma') of the atrioventricular node raises the possibility that this could also be related to Lyme infection and account for the relatively frequent occurrence of atrioventricular block in this condition. Lyme disease should always be considered in a case of atrioventricular block, particularly in a young patient from a rural area. The heart block tends to improve and therefore only temporary pacing may be required.
报告了一例发生在萨福克郡农场工人身上的莱姆病性心肌炎致死病例。心脏尸检显示心包炎、局灶性心肌炎以及显著的心内膜和间质纤维化。房室结内胚层异位（“间皮瘤”）这一额外发现增加了其也可能与莱姆感染有关的可能性，并解释了在这种情况下房室传导阻滞相对频繁发生的原因。对于房室传导阻滞病例，尤其是来自农村地区的年轻患者，应始终考虑莱姆病。心脏传导阻滞往往会改善，因此可能仅需要临时起搏。
