Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1990 Mar;63(3):162–168. doi: 10.1136/hrt.63.3.162

Range of atrioventricular conduction disturbances in Lyme borreliosis: a report of four cases and review of other published reports.

M R van der Linde 1, H J Crijns 1, J de Koning 1, J A Hoogkamp-Korstanje 1, J J de Graaf 1, D A Piers 1, A van der Galiën 1, K I Lie 1
PMCID: PMC1024396  PMID: 2183859

Abstract

Four patients with Lyme borreliosis had atrioventricular conduction disturbances. All four were positive for specific antibodies against Borrelia burgdorferi measured by indirect immunofluorescence tests. Biopsy specimens, which were obtained in three patients, showed band-like infiltrates of plasma cells and lymphocytes in the endocardium. There was diffuse infiltration of the interstitium of the myocardium by lymphocytes, plasma cells, and macrophages. In two patients single fibre necrosis was seen in the myocardium. Biopsy specimens of the heart showed spirochetes in all three patients and serial sections stained by the Bosma-Steiner technique showed that they resembled Borrelia burgdorferi. At follow up one patient had persistent complete atrioventricular block, despite treatment with antibiotics and corticosteroid, and a permanent pacemaker was implanted.

Full text

PDF
167

Images in this article

163Image
on p.163
163Image
on p.163
165Image
on p.165

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allal J., Coisne D., Thomas P., Vieyres C., Gallimard J. F., Becq-Giraudon B., Foullon P., Barraine R. Manifestations cardiaques de la maladie de Lyme. Ann Med Interne (Paris) 1986;137(5):372–374. [PubMed] [Google Scholar]
  2. Alpert L. I., Welch P., Fisher N. Gallium-positive Lyme disease myocarditis. Clin Nucl Med. 1985 Sep;10(9):617–617. doi: 10.1097/00003072-198509000-00002. [DOI] [PubMed] [Google Scholar]
  3. Ballmer P. E., Hany A. Lyme-Karditis. Schweiz Med Wochenschr. 1988 Mar 12;118(10):358–362. [PubMed] [Google Scholar]
  4. Bateman D. E., White J. E., Elrington G., Lawton N. F., Muhlemann M. F., Greenwood R. J. Three further cases of Lyme disease. Br Med J (Clin Res Ed) 1987 Feb 28;294(6571):548–549. doi: 10.1136/bmj.294.6571.548-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bedell S. E., Pastor B. M., Cohen S. I. Symptomatic high grade heart block in Lyme disease. Chest. 1981 Feb;79(2):236–237. doi: 10.1378/chest.79.2.236. [DOI] [PubMed] [Google Scholar]
  6. Burgdorfer W., Barbour A. G., Hayes S. F., Benach J. L., Grunwaldt E., Davis J. P. Lyme disease-a tick-borne spirochetosis? Science. 1982 Jun 18;216(4552):1317–1319. doi: 10.1126/science.7043737. [DOI] [PubMed] [Google Scholar]
  7. Cornuau C., Bernard M., Daumas P. L., Oblet B., Poirot G., Valois M. Les manifestations cardiaques de la maladie de Lyme. A propos de deux observations. Ann Cardiol Angeiol (Paris) 1984 Oct;33(6):395–399. [PubMed] [Google Scholar]
  8. Craft J. E., Grodzicki R. L., Steere A. C. Antibody response in Lyme disease: evaluation of diagnostic tests. J Infect Dis. 1984 May;149(5):789–795. doi: 10.1093/infdis/149.5.789. [DOI] [PubMed] [Google Scholar]
  9. Dattwyler R. J., Halperin J. J., Pass H., Luft B. J. Ceftriaxone as effective therapy in refractory Lyme disease. J Infect Dis. 1987 Jun;155(6):1322–1325. doi: 10.1093/infdis/155.6.1322. [DOI] [PubMed] [Google Scholar]
  10. De Koning J., Bosma R. B., Hoogkamp-Korstanje J. A. Demonstration of spirochaetes in patients with Lyme disease with a modified silver stain. J Med Microbiol. 1987 May;23(3):261–267. doi: 10.1099/00222615-23-3-261. [DOI] [PubMed] [Google Scholar]
  11. Dunica S., Piette J. C., Nassar N., Beaufils P. Une nouvelle cause de bloc auriculo-ventriculaire aigu transitoire: la maladie de Lyme. Arch Mal Coeur Vaiss. 1986 Jul;79(8):1251–1255. [PubMed] [Google Scholar]
  12. Duray P. H., Steere A. C. Clinical pathologic correlations of Lyme disease by stage. Ann N Y Acad Sci. 1988;539:65–79. doi: 10.1111/j.1749-6632.1988.tb31839.x. [DOI] [PubMed] [Google Scholar]
  13. Duray P. H. The surgical pathology of human Lyme disease. An enlarging picture. Am J Surg Pathol. 1987;11 (Suppl 1):47–60. doi: 10.1097/00000478-198700111-00005. [DOI] [PubMed] [Google Scholar]
  14. Goldings E. A., Jericho J. Lyme disease. Clin Rheum Dis. 1986 Aug;12(2):343–367. [PubMed] [Google Scholar]
  15. Hechemy K. E. Lyme disease: a review. Bull Soc Pathol Exot Filiales. 1986;79(1):9–21. [PubMed] [Google Scholar]
  16. Houwerzyl J., Root J. J., Hoogkamp-Korstanje J. A. A case of Lyme disease with cardiac involvement in the Netherlands. Infection. 1984 Sep-Oct;12(5):358–358. doi: 10.1007/BF01651154. [DOI] [PubMed] [Google Scholar]
  17. Kapusta P., Fauchier J. P., Cosnay P., Huguet R., Grézard O., Rouesnel P. Troubles conductifs sino-auriculaires et auriculo-ventriculaires de la maladie de Lyme. A propos de deux observations. Arch Mal Coeur Vaiss. 1986 Aug;79(9):1361–1366. [PubMed] [Google Scholar]
  18. Marcus L. C., Steere A. C., Duray P. H., Anderson A. E., Mahoney E. B. Fatal pancarditis in a patient with coexistent Lyme disease and babesiosis. Demonstration of spirochetes in the myocardium. Ann Intern Med. 1985 Sep;103(3):374–376. doi: 10.7326/0003-4819-103-3-374. [DOI] [PubMed] [Google Scholar]
  19. Meyer L. K., Swenson D. B. Lyme carditis: high-grade heart block in Lyme disease. Minn Med. 1987 Jun;70(6):345–346. [PubMed] [Google Scholar]
  20. O'Connell J. B., Henkin R. E., Robinson J. A., Subramanian R., Scanlon P. J., Gunnar R. M. Gallium-67 imaging in patients with dilated cardiomyopathy and biopsy-proven myocarditis. Circulation. 1984 Jul;70(1):58–62. doi: 10.1161/01.cir.70.1.58. [DOI] [PubMed] [Google Scholar]
  21. Olson L. J., Okafor E. C., Clements I. P. Cardiac involvement in Lyme disease: manifestations and management. Mayo Clin Proc. 1986 Sep;61(9):745–749. doi: 10.1016/s0025-6196(12)62775-x. [DOI] [PubMed] [Google Scholar]
  22. Parke A. From New to old England: the progress of Lyme disease. Br Med J (Clin Res Ed) 1987 Feb 28;294(6571):525–526. doi: 10.1136/bmj.294.6571.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Reznick J. W., Braunstein D. B., Walsh R. L., Smith C. R., Wolfson P. M., Gierke L. W., Gorelkin L., Chandler F. W. Lyme carditis. Electrophysiologic and histopathologic study. Am J Med. 1986 Nov;81(5):923–927. doi: 10.1016/0002-9343(86)90370-0. [DOI] [PubMed] [Google Scholar]
  24. Rienzo R. J., Morel D. E., Prager D., Barron L., Post R. Gallium avid Lyme myocarditis. Clin Nucl Med. 1987 Jun;12(6):475–476. doi: 10.1097/00003072-198706000-00017. [DOI] [PubMed] [Google Scholar]
  25. Schned E. S., Williams D. N. Lyme disease. The tick bite, the rash, and the sequelae. Postgrad Med. 1985 Apr;77(5):303-8, 310. doi: 10.1080/00325481.1985.11698969. [DOI] [PubMed] [Google Scholar]
  26. Stanek G., Wewalka G., Groh V., Neumann R., Kristoferitsch W. Differences between Lyme disease and European arthropod-borne Borrelia infections. Lancet. 1985 Feb 16;1(8425):401–401. doi: 10.1016/s0140-6736(85)91424-2. [DOI] [PubMed] [Google Scholar]
  27. Steere A. C., Bartenhagen N. H., Craft J. E., Hutchinson G. J., Newman J. H., Pachner A. R., Rahn D. W., Sigal L. H., Taylor E., Malawista S. E. Clinical manifestations of Lyme disease. Zentralbl Bakteriol Mikrobiol Hyg A. 1986 Dec;263(1-2):201–205. doi: 10.1016/s0176-6724(86)80123-7. [DOI] [PubMed] [Google Scholar]
  28. Steere A. C., Batsford W. P., Weinberg M., Alexander J., Berger H. J., Wolfson S., Malawista S. E. Lyme carditis: cardiac abnormalities of Lyme disease. Ann Intern Med. 1980 Jul;93(1):8–16. doi: 10.7326/0003-4819-93-1-8. [DOI] [PubMed] [Google Scholar]
  29. Steere A. C., Green J., Schoen R. T., Taylor E., Hutchinson G. J., Rahn D. W., Malawista S. E. Successful parenteral penicillin therapy of established Lyme arthritis. N Engl J Med. 1985 Apr 4;312(14):869–874. doi: 10.1056/NEJM198504043121401. [DOI] [PubMed] [Google Scholar]
  30. Steere A. C., Grodzicki R. L., Kornblatt A. N., Craft J. E., Barbour A. G., Burgdorfer W., Schmid G. P., Johnson E., Malawista S. E. The spirochetal etiology of Lyme disease. N Engl J Med. 1983 Mar 31;308(13):733–740. doi: 10.1056/NEJM198303313081301. [DOI] [PubMed] [Google Scholar]
  31. Steere A. C., Malawista S. E., Hardin J. A., Ruddy S., Askenase W., Andiman W. A. Erythema chronicum migrans and Lyme arthritis. The enlarging clinical spectrum. Ann Intern Med. 1977 Jun;86(6):685–698. doi: 10.7326/0003-4819-86-6-685. [DOI] [PubMed] [Google Scholar]
  32. Steere A. C., Malawista S. E., Newman J. H., Spieler P. N., Bartenhagen N. H. Antibiotic therapy in Lyme disease. Ann Intern Med. 1980 Jul;93(1):1–8. doi: 10.7326/0003-4819-93-1-1. [DOI] [PubMed] [Google Scholar]
  33. Steere A. C., Malawista S. E., Snydman D. R., Shope R. E., Andiman W. A., Ross M. R., Steele F. M. Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three connecticut communities. Arthritis Rheum. 1977 Jan-Feb;20(1):7–17. doi: 10.1002/art.1780200102. [DOI] [PubMed] [Google Scholar]
  34. de Koning J., Hoogkamp-Korstanje J. A., van der Linde M. R., Crijns H. J. Demonstration of spirochetes in cardiac biopsies of patients with Lyme disease. J Infect Dis. 1989 Jul;160(1):150–153. doi: 10.1093/infdis/160.1.150. [DOI] [PubMed] [Google Scholar]
  35. van der Linde M. R., Crijns H. J., Lie K. I. Transient complete AV block in Lyme disease. Electrophysiologic observations. Chest. 1989 Jul;96(1):219–221. doi: 10.1378/chest.96.1.219. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES