1/13. borrelia burgdorferi as a cause of Morgagni-adams-stokes syndrome. Long time follow-up study.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.- - - - - - - - - - ranking = 1keywords = burgdorferi (Clic here for more details about this article) |
2/13. Complete heart block due to lyme carditis.Lyme carditis is becoming a more frequent complication of lyme disease, primarily due to the increasing incidence of this disease in the united states. Cardiovascular manifestations of lyme disease often occur within 21 days of exposure and include fluctuating degrees of atrioventricular (AV) block, acute myopericarditis or mild left ventricular dysfunction and rarely cardiomegaly or fatal pericarditis. AV block can vary from first-, second-, third-degree heart block, to junctional rhythm and asystolic pauses. patients with suspected or known lyme disease presenting with cardiac symptoms, or patients in an endemic area presenting with cardiac symptoms with no other cardiac risk factors should have a screening electrocardiogram along with Lyme titers. We present a case of third-degree AV block due to Lyme carditis, illustrating one of the cardiac complications of lyme disease. This disease is usually self-limiting when treated appropriately with antibiotics, and does not require permanent cardiac pacing.- - - - - - - - - - ranking = 0.14608018568317keywords = lyme (Clic here for more details about this article) |
3/13. Mitochondrial dna deletion diagnosed by analysis of an endomyocardial biopsy specimen from a patient with kearns-sayre syndrome and complete heart block.Defects of mitochondrial dna have been found at necropsy in the myocardium of patients with kearns-sayre syndrome. A patient with characteristics typical of kearns-sayre syndrome and a complete heart block is described. Southern blot analysis showed a deletion of 3.3 kb in the mitochondrial dna in an endomyocardial biopsy specimen and in skeletal muscle. The deletion led to the disappearance of the genes for four transfer RNAs and four subunits of complex I (NADH:ubiquinone oxidoreductase) in the mitochondrial respiratory chain. The defect could not be demonstrated in whole blood despite amplification of the mitochondrial dna region of interest by the polymerase chain reaction technique. There can be heteroplasmy--that is, normal and abnormal mitochondrial dna populations in one cell--in different tissues, and the degree of heteroplasmy may be crucial in the development of organ-specific symptoms. This patient raises the possibility that some tissues can be specifically enriched with mitochondria with dna defects and emphasises the need for elective sampling of the target tissue and polymerase chain reaction technique to exclude these defects. The role of mitochondrial dna defects in idiopathic cardiomyopathies could perhaps be studied by analysis of mitochondrial dna from endomyocardial biopsy specimens.- - - - - - - - - - ranking = 0.073040092841586keywords = lyme (Clic here for more details about this article) |
4/13. Diagnostic dilemma for the 1990s: lyme disease versus rheumatic fever.A 15-year-old boy developed an annular erythematous skin rash, fever, knee pain, syncope, and was found to be in complete heart block requiring temporary transvenous pacing. His recovery was complete following therapy with high dose steroids, aspirin, and IV ceftriaxone followed by oral penicillin. serologic tests documented diagnostic levels of antibodies to borrelia burgdorferi as well as to Group A streptococcal DNase B. Diagnoses of both lyme disease and rheumatic fever are based on clinical presentation and serologic confirmation. Our patient had a clinical presentation compatible with either diagnosis and serologic test results suggestive of infection by both B burgdorferi and Group A streptococci. The patient's management was aimed at preventing complications of both diseases, since clinicians involved with the patient's case could not agree on the most likely diagnosis. We present this case to emphasize the following: both rheumatic fever and lyme disease should be considered in patients presenting with annular skin rashes and complete heart block; serologic studies may be confusing in both lyme disease and rheumatic fever since neither is entirely sensitive nor specific and efforts should be made to document the causative organism by appropriate cultures, biopsies, and stains when possible; and improved immunoserologic testing for lyme disease, in particular, is highly needed.- - - - - - - - - - ranking = 0.4keywords = burgdorferi (Clic here for more details about this article) |
5/13. Range of atrioventricular conduction disturbances in Lyme borreliosis: a report of four cases and review of other published reports.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.- - - - - - - - - - ranking = 0.4keywords = burgdorferi (Clic here for more details about this article) |
6/13. Persistent atrioventricular block in Lyme borreliosis.Cardiac manifestations are reported in 0.3%-4.0% of European patients with borrelia burgdorferi (B.b.) infection. Usually symptoms disappear within 6 weeks. We report a case with persistent impairment of atrioventricular (AV) conduction. diagnosis was confirmed by demonstration of IgM antibodies and increase of IgG antibody titers against B.b. in serum, by isolation of the spirochete from skin biopsy material and by the typical clinical combination of erythema migrans, Bannwarth syndrome (meningoradiculitis), and complete heart block. Despite immediate antibiotic therapy with ceftriaxone, first degree AV block and second degree block Wenckebach with atrial pacing at 100 beats/minute persisted for 2 years. We conclude, that Lyme carditis can cause long-standing or irreversible AV conduction defects despite adequate and early antimicrobial therapy.- - - - - - - - - - ranking = 0.2keywords = burgdorferi (Clic here for more details about this article) |
7/13. Temporary pacing in complete heart block due to lyme disease: a case report.The authors present the case of a 44-year-old man who was admitted with complete heart block and signs of severe bradycardia. After steroid administration and temporary pacemaker treatment the complete heart block resolved. During this therapy transient ST segment and T wave abnormalities occurred. The positive borrelia burgdorferi antibody titer arrived only after therapy had been completed. This is regarded as the first case of Lyme carditis with complete heart block diagnosed in eastern europe. Carditis resolved without antibiotic treatment and has not recurred.- - - - - - - - - - ranking = 0.2keywords = burgdorferi (Clic here for more details about this article) |
8/13. Demonstration of spirochetes in cardiac biopsies of patients with lyme disease.Cardiac involvement occurring early in borrelia burgdorferi infection is a clinical manifestation of human lyme disease. Therefore, two patients with acute complete atrioventricular heart blocks and unexplained recurrent dizziness were studied. Both patients had significantly elevated serum titers of IgM and IgG antibodies to B. burgdorferi. Right ventricular subendocardial biopsies showed dense infiltrates consisting of lymphocytes and plasma cells. silver staining revealed spirochetes characteristic of B. burgdorferi near and in the infiltrates, between the muscle fibers, and in the endocardium. One patient responded to penicillin; the other did not, necessitating installation of a pacemaker. Thus, permanent heart damage may result from cardiac involvement in lyme disease.- - - - - - - - - - ranking = 0.6keywords = burgdorferi (Clic here for more details about this article) |
9/13. Complete heart block in a dog seropositive for borrelia burgdorferi. Similarity to human Lyme carditis.lyme disease has been recognized in humans since 1975 when it was associated with an outbreak of oligoarthritis in children in Lyme, connecticut. erythema chronicum migrans (ECM) is a clinical marker for the human disease, which usually appears within 3 to 32 days after an infected tick bite. lyme disease is caused by spirochete, borrelia burgdorferi, which is vectored by the hard ticks ixodes dammini or ixodes pacificus in the united states. In humans, lyme disease has been found to cause a variety of clinical syndromes including cardiopathy, neuropathy, dermatopathy, and arthropathy. Human Lyme carditis is characterized by varying degrees of atrioventricular (AV) heart block that usually resolve regardless of therapy. lyme disease has been reported in the dog as an arthropathy. This article reports a case of complete heart block and myocarditis in a dog with a positive titer for B burgdorferi, in which clinical and pathologic findings were similar to those seen in human Lyme myocarditis.- - - - - - - - - - ranking = 1.2keywords = burgdorferi (Clic here for more details about this article) |
10/13. Lyme carditis: indications for cardiac pacing.lyme disease is a tick-borne illness caused by the spirochete borrelia burgdorferi. It is the most common reported vector-borne illness in the united states. The clinical course of lyme disease is divided into early and late phases. Early disease may be limited or disseminated. Generally, cardiac complications occur in the early disseminated phase. Disturbance of atrioventricular conduction is the most commonly recognized cardiac manifestation of lyme disease. This is usually self-limited and does not require permanent cardiac pacing. A case of Lyme carditis with atrioventricular block requiring permanent pacing is reported and the indications for cardiac pacing in this disease are reviewed.- - - - - - - - - - ranking = 0.2keywords = burgdorferi (Clic here for more details about this article) |
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