[Transient complete AV block as a sequela of Borrelia myocarditis].

Abstract

A 49-year-old man suddenly developed dyspnoea, sweating, fever (up to 38.5 degrees C), vertigo and angina. After emergency admittance to hospital the ECG showed 3 degrees A-V block, requiring temporary pacemaker insertion. The patient reported that a month before he had been bitten, probably by a tick. Serological tests demonstrated a recent Borrelia infection (rise of IgG antibody titre to 1:2048, IgM antibody titre to 1:128). Coronary angiography excluded any haemodynamically significant coronary heart disease as a cause of the conduction disorder. Myocardial biopsy showed changes pointing to a past myocarditis. This suggested Borrelia infection as the cause of the complete A-V block. Under treatment with broad-spectrum antibiotics for 15 days the fever subsided and the ECG became normal. Shortly before discharge, an elevated pulmonary wedge pressure on 150 W exercise indicated persistence of mild left-ventricular failure.

• Authors: K M Kruse, R Gust, W Grosse-Heitmeyer
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 117 Issue 5 Pg. 167-71 (Jan 31 1992) ISSN: 0012-0472 [Print] Germany
• Vernacular Title: Passagere komplette AV-Blockierung als Folge einer Borrelienmyokarditis.
• PMID: 1735375 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antibodies, Bacterial

Topics

• Antibodies, Bacterial (blood)
• Borrelia burgdorferi Group (immunology)
• Cardiac Catheterization
• Drug Therapy, Combination
• Electrocardiography
• Heart Block (diagnosis, etiology, therapy)
• Humans
• Lyme Disease (complications, diagnosis, therapy)
• Male
• Middle Aged
• Myocarditis (complications, diagnosis, therapy)
• Pacemaker, Artificial