Editorial

Lyme Carditis: Another Diagnostically Elusive Spirochetal Disease

Authors: Jack P. Chen, MD, FACC, FSCAI, FCCP

Abstract

The differential diagnosis of acquired atrioventricular cardiac conduction disturbances includes pharmacologic agents as well as collagen-vascular, infiltrative, and infectious diseases.1 Commonly prescribed cardiac medications such as beta and calcium blockers, in addition to digoxin, are well-known negative chronotropes. Conduction defects can be observed in up to 50% of ankylosing spondylitis and scleroderma cases, as well as in 10% of patients with rheumatoid arthritis.2–4 Although infiltrative myocardial processes such as amyloidosis, sarcoidoisis, and hemochromatosis are usually associated with cardiomyopathy, electrophysiologic aberrations have also been reported. Typically, the basal interventricular septum is involved; other manifestations include papillary muscle dysfunction and heart failure.5,6

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