12-year-old boy suffers cardiac arrest due to Lyme disease

In the February 2017 issue of HeartRhythm Case Reports, doctors describe what they believe is the first case of a Lyme disease patient presenting as fulminant myocarditis and cardiac arrest. Lyme disease has been associated with junctional ectopic tachycardia (JET) and fascicular tachycardia. In this instance, JET was secondary to fulminant myocarditis.

 

by Daniel J. Cameron, MD MPH

“The patient is a 12-year-old previously healthy boy with a recent history of participation in an outdoor camp for 2–3 weeks who began to gasp for air while riding as a passenger in a car, with subsequent cyanosis and cardiac arrest, following participation in recreational outdoor activities earlier that afternoon,” states Cunningham from the Division of Cardiology, Children’s National Health System, Washington, D.C.

Lyme disease triggers cardiac arrest in 12-year-old boy.

The boy received cardiopulmonary resuscitation for pulseless arrest and ventricular fibrillation. Spontaneous circulation returned “after 8 minutes of cardiopulmonary resuscitation, including defibrillation, intubation, and intravenous (IV) epinephrine and lidocaine administration,” according to Cunningham and colleagues. [1]

He required intensive therapy in the pediatric intensive care unit that included extreme hypoxemia, challenging ventilation, and persistent tachyarrhythmias including fascicular tachycardia. His treatment included high dose dopamine, norepinephrine, ceftriaxone, and procainamide. Procainamide was changed to amiodarone due to hypotension.

Serologic tests were remarkable for a strongly positive enzyme-linked immunosorbent assay (ELISA), as well as positive IgG antibodies and IgM Western blot test for Lyme disease. Intravenous ceftriaxone was continued for 21 days with normalization of his ejection fraction.

Following his participation in an outdoor camp, a 12-year-old boy suffers sudden cardiac arrest, later attributed to Lyme disease.

While the boy made a full recovery of his cardiac functioning, he did have neurologic injury which required long-term rehabilitation. Brain imaging revealed he suffered from a global cerebral edema and moderate hypoxic injury to the basal ganglia, hippocampi, and primary motor and visual cortices. The damage, Cunningham explains, left him “with altered mental status, agitation, and dysautonomia.”

The authors did not address whether the neurologic symptoms could be due to a persistent tick-borne infection yet to be identified.

Related posts:

What might sudden cardiac death due to Lyme disease look like?

Relying on a negative Lyme disease test can prove deadly

How Lyme myocarditis might present in an adolescent patient

 

References:

  1. Cunningham MEA, Doroshow R, Olivieri L, Moak JP. Junctional ectopic tachycardia secondary to myocarditis associated with sudden cardiac arrest. HeartRhythm Case Rep. 2017;3(2):124-128.


3 Replies to "12-year-old boy suffers cardiac arrest due to Lyme disease"

  • David R Thomas
    06/02/2017 (12:39 am)
    Reply

    I also in 2001, started to spiral downhill to cardiac failure. It is good to see this child’s Lyme issues recognized. We have come a fair distance with Lyme related issues in 17 years.
    Thanks for sharing with the public,

  • Matt
    06/02/2017 (2:57 am)
    Reply

    Our health care system is failing us “lymies”. Tests are outdated, doctors refuse to treat this disease in fear of retaliation from the CDC and Insurance. More than 300’000 per year are affected(double breast cancer patients) yet no hope in sight.

  • Nicole
    06/04/2017 (7:58 pm)
    Reply

    I am a healthy 48 year old woman that on August after struggling for a week from shortness of breath, heart palpitation and overall fatigue I was rushed to the hospital with complete heart block. Within this first 12 hours my heart rate plummeted to below 20 and was rushed into surgery where I was given a temporary pace maker. Long story short I was put on intravenous antibiotic for the suspected Lyme disease. Although after 9 days and no changes, the dr. was not sure if in fact it was Lyme. Day 10 in CCU and the medication started to work. Subsequently my heart corrected itself after approximately 1+ month, and the I am pace maker free. I was luck enough to catch it before it caused more damage. Hope the 12 year old continues to recover form his BI. I too know what that’s like as my son was hit my a cars in 2013 and suffered a TBI.


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