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J Electrocardiol. 2019 Jan - Feb;52:109-111. doi: 10.1016/j.jelectrocard.2018.12.005. Epub 2018 Dec 6.

A tick beat in the electrocardiogram: Persistent third degree block as only manifestation of Lyme disease.

Author information

1
Internal Medicine Department, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico. Electronic address: raulalbertojc10@gmail.com.
2
Internal Medicine Department, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.

Abstract

Lyme disease is the most common tick-borne illness in North America. A 23-year-old female presented to our emergency department with a chief complaint of sudden dyspnea and chest pain. An electrocardiogram revealed a third degree heart block. She was a resident of the Northeast region of Mexico and referred a recent travel to an endemic area for Borrelia burgdorferi in the center of Mexico in the past weeks. Lyme carditis was diagnosed after enzyme linked immunosorbent assay for IgM antibodies against B. burgdorferi was reported positive and corroborated by a confirmatory immunoblot analysis. Persistent AV block was the only manifestation in our patient, a presentation scarcely reported in literature.

KEYWORDS:

Complete AV block; Dyspnea; Lyme carditis; Syncope

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