HEART BLOCK Coronary conduction block

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
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Joe Ham
Posts: 489
Joined: Fri 27 Jul 2007 6:15
Location: New Mexico, USA

HEART BLOCK Coronary conduction block

Post by Joe Ham » Sun 28 Oct 2007 17:25

Wien Klin Wochenschr. 1999 Dec 10;111(22-23):964-9.

Borrelia burgdorferi as a cause of Morgagni-Adams-Stokes syndrome. Long time follow-up study.

Bartunek P, Mrázek V, Varejka P, Gorican K, Zapletalová J, Sklenár T.
IVth Department of Internal Medicine, Charles University, Prague, Czech Republic. pbart@LF1.CUNI.CZ

According the literature atrio-ventricular blockade (AVB) is the most frequent and well-known symptom of Lyme carditis. Typical signs of complete AVB include fatigue, lethargy and syncope- Morgagni-Adams-Stokes syndrome (MAS).

The authors present their results and experience with 5 patients selected from a long-term study (conducted between 1987 and 1998) comprising 58 patients who developed MAS. The authors tried to evaluate the changes especially in the cardiovascular system. They correlated the clinical state with ECG findings, as well as with the levels of the Borrelia burgdorferi antibodies.

The following results were obtained:
1) all patients had typical syncope,
2) the clinical course was not complicated (except one patient who developed ventricular fibrillation),
3) two patients had frequent symptomatic and asymptomatic arrhythmia including chest pain and episodic rest dyspnea,
4) subjective difficulties (usually palpitations) correlated with ECG findings (Lown 3a, 3b).

The authors also looked for any relationship between clinical difficulties and levels of antibodies. The results obtained with an early permanent pacemaker were less favourable than those reported in the literature.

Despite early treatment 2 patients had repeated palpitations and ECG correlates during the next years.
[Did they consider the possibility of persistent infection? If so, was it dismissed due to negative serology?]

PMID: 10666810 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/sites/entre ... d_RVDocSum

Joe Ham
Posts: 489
Joined: Fri 27 Jul 2007 6:15
Location: New Mexico, USA

Re: HEART BLOCK Coronary conduction block

Post by Joe Ham » Sun 28 Oct 2007 19:32

Ned Tijdschr Geneeskd. 2007 Sep 1;151(35):1941-4.Links
[Total atrioventricular block following a tick bite]
[Article in Dutch]

Verbunt RJ, Visser RF.
Máxima Medisch Centrum, Postbus 7777, 5500 MB Veldhoven. r.verbunt@mmc.nl

A 40-year-old man was referred to the cardiology outpatient clinic with dizziness, palpitations and shortness of breath. He remembered being bitten by a tick two to three years previously, but had not noticed a characteristic skin rash.

The ECG showed a prominent first degree atrioventricular (AV) block and ambulatory electrocardiographic monitoring showed an intermittent complete AV block.

A definitive pacemaker was implanted. Antibodies to Borrelia were found. The patient was treated with ceftriaxone. In the weeks and months following implantation, the AV block disappeared completely.

The reversibility of the AV block secured the diagnosis 'Lyme carditis with secondary AV block', and the pacemaker was explanted.

PMID: 17907546 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/sites/entre ... d_RVDocSum

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