Batikyan Ashot, Harutyunyan Hakob, Tamazyan Vahagn, Khachatryan Aleksan, Abalyan Pavel, Borkowski Pawel
Department of Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center/North Central Bronx Hospital, Bronx, USA.
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, USA.
Cureus. 2025 Mar 17;17(3):e80724. doi: 10.7759/cureus.80724. eCollection 2025 Mar.
Lyme disease, the most common tick-borne infection in North America, can lead to multi-organ involvement, including Lyme carditis. This report describes the case of a 42-year-old male who presented with a third-degree atrioventricular (AV) block due to Lyme carditis. The patient reported a history of a recent tick bite and erythema migrans rash, followed by progressive fatigue, palpitations, and dyspnea. Initial electrocardiogram (EKG) revealed third-degree AV block with ventricular escape rhythm, necessitating temporary transvenous pacing and intravenous ceftriaxone therapy. Within 48 hours, the patient significantly improved, transitioning to first-degree AV block with a decreasing PR interval. After clinical stabilization, intravenous ceftriaxone was switched to oral doxycycline, and the patient was discharged with outpatient follow-up. This case emphasizes the significance of early recognition and treatment of Lyme carditis to prevent life-threatening complications and avoid unnecessary permanent pacemaker implantation.
莱姆病是北美最常见的蜱传感染疾病，可导致多器官受累，包括莱姆心肌炎。本报告描述了一名42岁男性患者，因莱姆心肌炎出现三度房室传导阻滞。患者报告近期有蜱叮咬史及游走性红斑皮疹，随后出现进行性疲劳、心悸和呼吸困难。初始心电图（EKG）显示三度房室传导阻滞伴心室逸搏心律，需要临时经静脉起搏及静脉注射头孢曲松治疗。48小时内，患者病情显著改善，转变为一度房室传导阻滞，PR间期缩短。临床稳定后，静脉注射头孢曲松改为口服多西环素，患者出院并进行门诊随访。该病例强调了早期识别和治疗莱姆心肌炎对于预防危及生命的并发症及避免不必要的永久性起搏器植入的重要性。
