LYME CARDITIS IN A CLINICAL PRACTICE

Volodymyr Dzhyvak; Nadiya  Yarema; Kateryna  Myndziv

doi:10.5937/afmnai41-39831

Volodymyr Dzhyvak I. Horbachevsky Ternopil National Medical University
Nadiya Yarema I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine https://orcid.org/0000-0002-4378-1084
Kateryna Myndziv I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine https://orcid.org/0000-0003-1025-973X

DOI: https://doi.org/10.5937/afmnai41-39831

Keywords: myocarditis, Lyme carditis, AV-block, diagnostics, treatment.

Abstract

Introduction: Lyme disease is an infectious transmissible disease transmitted by the Ixodes ticks and is manifested by damaging of various organs and systems (most often - migrating erythema, damage to the nervous system, musculoskeletal system, heart, liver and eyes). According to various authors, heart damage in Lyme borreliosis is from 4 to 10% and is an understudied pathology.

A case report. The article describes a clinical case of infectious myocarditis associated with Lyme disease in a 51-year-old patient. The course of the disease and the results of treatment of the patient are analyzed. The severe rhythm and conduction disorders were revealed: AV-block of the first degree, transient AV-block of the II degree (Mobitz 2) and III degree, polytopic extrasystoles. Due to timely diagnosis, including serological, prescribed etiotropic antibacterial treatment, the patient achieved a significant improvement in both clinical condition and positive serological and ECG dynamics with improved AV conduction.

Conclusions. The most frequent ECG changes in Lyme carditis are conduction disorders with development of blockades of various stages. For the patients with myocarditis, which is accompanied by complex arrhythmias and conduction disorders and SILC scale medium and high risk, should be recommended serological examination in order to verify the borreliosis etiology of myocarditis. In this particular case early diagnostics and prescribed etiotropic treatment, in addition to treatment of heart failure, contributed to a significant improvement in both the clinical condition and positive serological and ECG dynamics.

Keywords: myocarditis, Lyme carditis, AV-block, diagnostics, treatment.

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