Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, USA.
Department of Medicine, The University of Vermont Medical Center, Burlington, USA.
J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221098333. doi: 10.1177/23247096221098333.
Lyme disease is commonly encountered in endemic areas of the United States harboring the causal organism . Lyme carditis can manifest in early disseminated infections, usually as atrioventricular nodal blockade. Timely antibiotic therapy typically suppresses myocardial inflammation and reverses cardiac conduction disturbances. We present a case of a previously healthy male who presented to the emergency department with non-prodromal syncope, multifocal annular rashes, and antecedent inflammatory knee pain and effusion, found to have positive 2-tier Lyme testing and pause-dependent polymorphic ventricular tachycardia leading to cardiac arrest. Lyme carditis occurs in early disseminated infections but rarely leads to cardiac arrest. Acute management is entrained in well-established guidelines for therapy, and together with risk stratification scoring can be considered by emergency care physicians in the workup of undifferentiated syncope with concern for Lyme disease with cardiac involvement.
莱姆病在美国的流行地区很常见，这些地区存在着致病生物。莱姆心炎可在早期播散性感染中表现出来，通常表现为房室结阻滞。及时的抗生素治疗通常可抑制心肌炎症并逆转心脏传导障碍。我们报告了一例既往健康的男性患者，他因非前驱性晕厥、多灶性环状皮疹、先前的炎性膝关节疼痛和积液而到急诊科就诊，检查发现 2 级莱姆病检测呈阳性，伴有依赖停顿的多形性室性心动过速导致心脏骤停。莱姆心炎发生在早期播散性感染中，但很少导致心脏骤停。急性管理遵循既定的治疗指南，并且可以由急诊医生在对疑似莱姆病合并心脏受累的非特异性晕厥进行评估时，结合风险分层评分进行考虑。
