Dr. Daniel Cameron: Inside Lyme Podcast
16-year-old male with Lyme disease presenting with palpitations and chest pain
Welcome to another edition of Inside Lyme Podcast with Dr. Daniel Cameron. I will be discussing a case featuring a 16-year-old boy who exhibited cardiac symptoms, including palpitations and chest pain, due to Lyme disease. The boy was later diagnosed with Lyme carditis.
A 16-year-old male with Lyme disease presenting with palpitations and chest pain – an Inside Lyme case study.
In the Journal of BMC Infectious Diseases, Myers and colleagues describe a 16-year-old male with Lyme disease, who presented with palpitations and chest pain.  The erythema migrans rash was discovered during a physical examination.
The adolescent was diagnosed with Lyme carditis based on a first degree heart block by EKG. Laboratory findings confirmed the presence of Lyme disease.
Unfortunately, his heart block progressed. “The hospital course was further remarkable for transition to 2nd degree heart block and transient episodes of complete heart block,” wrote Myers and colleagues.
In such cases, the authors recommend admission. “Any patient with suspected Lyme carditis manifesting cardiac symptoms such as syncope, chest pain, or EKG changes should be admitted for parenteral antibiotic therapy and cardiac monitoring.”
Additionally, the authors remind readers that there are other manifestations of Lyme disease. “Other manifestations of Lyme carditis may include myopericarditis, left ventricular dysfunction, and cardiomegaly.”
Fortunately, the young man with Lyme disease and cardiac symptoms did well after treatment with IV ceftriaxone followed by oral doxycycline. He was discharged after 10 days. He completed 28 days of doxycycline.
Author’s Take Away: “First, this case illustrates that signs and symptoms of cardiac disease (palpitations, chest pain) may be the chief complaint of patients with [Lyme disease] in pediatric practice.”
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- Myers F, Mishra PE, Cortez D, Schleiss MR. Chest palpitations in a teenager as an unusual presentation of Lyme disease: case report. BMC Infect Dis. 2020;20(1):730.
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