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Lyme Carditis: Cardiac Abnormalities of Lyme Disease

ALLEN C. STEERE, M.D.; WILLIAM P. BATSFORD, M.D.; MARC WEINBERG, M.D.; JONATHAN ALEXANDER, M.D.; HARVEY J. BERGER, M.D.; STEVEN WOLFSON, M.D.; and STEPHEN E. MALAWISTA, M.D.
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Grant support: in part by U. S. Public Heath Service Grants AM-20358, AM-10493, AM-07107, AM-5639, RR-05443, RR-00125, HL21690; the Arthritis Foundation and its Connecticut Chapter; and the Kroc Foundation, Santa Ynez, California.

▸Requests for reprints should be addressed to Allen C. Steere, M.D.; Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street; New Haven, CT 06510.


New Haven, Connecticut


© 1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;93(1_Part_1):8-16. doi:10.7326/0003-4819-93-1-8
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We studied 20 patients, mostly young adult men, with cardiac involvement of Lyme disease. The commonest abnormality (18 patients) was fluctuating degrees of atrioventricular block; eight of them developed complete heart block. Thirteen patients had evidence of more diffuse cardiac involvement: electrocardiographic changes compatible with acute myopericarditis (11 patients), radionuclide evidence of mild left ventricular dysfunction (five of 12 patients tested), or frank cardiomegaly (one patient). Heart involvement was usually preceded by erythema chronicum migrans and sometimes accompanied by meningoencephalitis, facial palsy, arthritis, elevated serum IgM levels, or cryoglobulins containing IgM. The duration of cardiac involvement was usually brief (3 days to 6 weeks). The clinical picture in these patients has similarities to acute rheumatic fever; but in Lyme disease, complete heart block may be commoner, myopericardial involvement tends to be milder, and valves seem not to be affected.

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