Case studies: Lyme disease an infection causes carditis

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Lyme carditis happens when Lyme disease micro organism penetrates the center’s tissues and disrupts electrical alerts. Pericarditis entails irritation of the skinny, saclike tissue surrounding the center. Investigators describe two circumstances wherein Lyme disease led to cardiac issues.

Of their article, “Lyme-Associated Pericarditis: A Case Report and Literature Review,” Ameer and colleagues describe an 18-year-old man who developed pericarditis attributable to Lyme disease.1

The affected person who had a medical historical past of bronchial asthma, irritable bowel syndrome, and obsessive-compulsive dysfunction offered to the emergency division with complaints of chest ache.

The ache was intense – 8 on a scale of 10 and situated within the heart of his chest. The ache woke him up from sleep and was related to shortness of breath and palpitations.

“The ache worsened with mendacity down, whereas taking deep breaths, and coughing. Leaning ahead, nonetheless, lowered the ache,” the authors state.

Per week previous to the onset of his signs, the person reported having a rash on his again. Though he didn’t recall a tick chunk, he lived in a closely wooded space of jap Pennsylvania.

In line with the authors, “an examination revealed an erythematous oval rash in the fitting scapular and sub-scapular area with central clearing, measuring roughly 5 x 3 inches.”

The affected person’s EKG findings have been in keeping with pericarditis. And though testing for Lyme disease was destructive, the person was recognized with Lyme-induced pericarditis.

Pericarditis is swelling and irritation of the skinny, saclike tissue surrounding the center.2

His coronary heart palpitations and shortness of breath resolved fully and his chest ache improved following remedy with ibuprofen, colchicine and intravenous ceftriaxone.

“In sufferers with signs suggestive of Lyme pericarditis, empiric remedy must be administered instantly, even earlier than Lyme serology is processed,” the authors state.

Moreover, they state, cardiac involvement attributable to Lyme disease can have deadly outcomes, together with third-degree coronary heart block. “A destructive take a look at within the preliminary section of the illness can’t rule out the illness.”

Lyme disease causes carditis in 45-year-old man

A forty five-year-old man was admitted to the hospital with left sided chest ache. 4 days earlier, he developed a fever, muscle aches, neck and again stiffness, headache, chills, diaphoresis, and nausea.

The affected person had been looking three weeks earlier than his signs started. One week previous to admission, he seen an erythematous (EM) rash on his shoulder.

“It had progressed from a small bug chunk to a bigger, 4 × 3 cm erythematous, painless, nonpruritic, targetoid bull-eyes rash,” states Michalski et al.3

The person was handled empirically for Lyme carditis with IV ceftriaxone. His signs resolved following remedy.

“This case illustrates the significance of thorough historical past taking and intensive bodily examination when assessing a case of attainable acute myocardial infarction,” the authors state.

 

References:
  1. Ameer MA, Patlolla SR, Patel N, Mehta R, Babar M. Lyme-Related Pericarditis: A Case Report and Literature Assessment. Cureus. 2024 Feb 12;16(2):e54096. doi: 10.7759/cureus.54096. PMID: 38487108; PMCID: PMC10937846.
  2. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pericarditis/symptoms-causes/syc-20352510
  3. Michalski et al. Lyme Carditis Buried Beneath ST-Phase Elevations. Case studies in cardiology. Quantity 2017. https://doi.org/10.1155/2017/9157625

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