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Lyme Disease Masquerading as Acute Coronary Syndrome

Tamez, Hector MD, MPH*; Gelfand, Eli MD†

Infectious Diseases in Clinical Practice: July 2011 - Volume 19 - Issue 4 - pp 293-296
doi: 10.1097/IPC.0b013e3182002f4a
Case Reports

Lyme borreliosis is the most common tick-borne disease in the United States. It is caused by spirochetes of the Borrelia burgdorferi species complex. Lyme disease has a myriad of incident symptoms, which can involve the skin as well as the musculoskeletal, neurologic, and cardiovascular systems. Cardiac manifestations usually involve the conduction system, but it may involve the endocardium, myocardium, or pericardium. We report a case where Lyme disease initially presented with chest pain and ST elevations in the inferolateral leads suggestive of an acute coronary syndrome. Patient had myocardial involvement on magnetic resonance imaging. Twenty-eight days later in follow-up, he had atrioventricular conduction delay. Enzyme-linked immunoassay and Western blot were positive for Lyme disease (IgM and IgG). Signs and symptoms resolved after therapy with doxycycline.

From the *Department of Medicine and †The CardioVascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Correspondence to: Hector Tamez, MD, MPH, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215. E-mail: tamez.hector@gmail.com.

The authors have no funding or conflicts of interest to disclose.

© 2011 Lippincott Williams & Wilkins, Inc.