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莱姆病性心脏病的表现。

Manifestations of Lyme carditis.

作者信息

Kostić Tomislav, Momčilović Stefan, Perišić Zoran D, Apostolović Svetlana R, Cvetković Jovana, Jovanović Andriana, Barać Aleksandra, Šalinger-Martinović Sonja, Tasić-Otašević Suzana

机构信息

Clinic for Cardiovascular Diseases, Clinical Center Niš, Blvd Zorana Djindjica 48, 18000 Niš, Serbia; Department of Cardiology, Faculty of Medicine, University of Niš, Serbia, Blvd Zorana Djindjica 81, 18000 Niš, Serbia.

Clinic for Cardiovascular Diseases, Clinical Center Niš, Blvd Zorana Djindjica 48, 18000 Niš, Serbia.

出版信息

Int J Cardiol. 2017 Apr 1;232:24-32. doi: 10.1016/j.ijcard.2016.12.169. Epub 2016 Dec 27.

Abstract

The first data of Lyme carditis, a relatively rare manifestation of Lyme disease, were published in eighties of the last century. Clinical manifestations include syncope, light-headedness, fainting, shortness of breath, palpitations, and/or chest pain. Atrioventricular (AV) electrical block of varying severity presents the most common conduction disorder in Lyme carditis. Although is usually mild, AV block can fluctuates rapidly and progress from a prolonged P-R interval to a His-Purkinje block within minutes to hours and days. Rarely, Lyme disease may be the cause of endocarditis, while some studies and reports, based on serological and/or molecular investigations, have suggested possible influence of Borrelia burgdorferi on degenerative cardiac valvular disease. Myocarditis, pericarditis, pancarditis, dilated cardiomyopathy, and heart failure have also been described as possible manifestations of Lyme carditis. The clinical course of Lyme carditis is generally mild, short term, and in most cases, completely reversible after adequate antibiotic treatment.

摘要

莱姆病性心肌炎是莱姆病相对罕见的一种表现形式,其首批数据于上世纪八十年代发表。临床表现包括晕厥、头晕、昏厥、呼吸急促、心悸和/或胸痛。不同严重程度的房室(AV)电传导阻滞是莱姆病性心肌炎最常见的传导障碍。虽然通常较轻,但AV阻滞可能迅速波动,在数分钟至数小时甚至数天内从P-R间期延长发展为希氏束-浦肯野纤维阻滞。莱姆病很少会引发心内膜炎,而一些基于血清学和/或分子研究的报告表明,伯氏疏螺旋体可能对退行性心脏瓣膜病有影响。心肌炎、心包炎、全心炎、扩张型心肌病和心力衰竭也被描述为莱姆病性心肌炎可能的表现形式。莱姆病性心肌炎的临床病程通常较轻、病程较短,且在大多数情况下,经过充分的抗生素治疗后可完全逆转。

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