LYME CARDITIS: A RARE CASE OF ABORTED SUDDEN CARDIAC ARREST

TOPIC: Cardiovascular Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: Lyme disease (LD) is the most common tick-borne in US. Cardiac involvement occurs up to 8% of untreated cases. (1) Even though only eleven cases fatal carditis (LC) were reported worldwide between 1985 and 2019, it can be life-threatening. (2) We present a rare case LC leading cardiac arrest who was successfully saved. CASE PRESENTATION: A young healthy male from Ohio river valley presented July after syncopal episode. He had fever, rash, malaise for two weeks before admission. There no personal or family history illness. Vitals auscultation normal, but he multiple erythematous patches over abdomen. Initial labs positive mild troponin elevation. Electrocardiogram (EKG) showed complete heart block (CHB) with right bundle branch (RBBB). placed on telemetry monitoring doxycycline started infection. On same day admission, pulseless ventricular tachycardia return spontaneous circulation resuscitation. Extensive testing evaluate cause pursued. Echocardiography MRI did not reveal any structural anomaly CT coronary angiography normal anatomy patent vasculature. Serologies LD which confirmed Western blot. treated ceftriaxone resulting resolution CHB RBBB by fifteen hospitalization. DISCUSSION: caused Borrelia burgdorferi transmitted Ixodes tick. Most occur June-July show predominance. It classically divided into three stages. The second stage an early disseminated phase characterized ≥2 erythema migrans lesions along nervous system involvement. Within days tick bite, spirochetes invade tissue via bloodstream, causing LC. Atrio-ventricular manifestation fluctuate rapidly progress CHB. (3) Other complications include peri-myocarditis, arrhythmias infrequently involves valves vessels. Antibiotics prevent very rarely they life threatening. This emphasizes need continuous patient high risk decompensation despite treatment. CONCLUSIONS: Keeping suspicion thorough examination especially endemic area unexplained abnormalities vital. highlights fact that antibiotics. Intensive inpatient must pursued until conduction are longer REFERENCE #1: Haddad FA, Nadelman RB. heart. Front Biosci. 2003 Sep 1;8:s769-82. doi: 10.2741/1065. PMID: 12957829. #2: Centers Control Prevention. Carditis at: https://www.cdc.gov/lyme/treatment/lymecarditis.html. Assessed 4/28/2021 #3: Yeung C, Baranchuk A. Diagnosis Treatment Carditis: JACC Review Topic Week. J Am Coll Cardiol. 2019 Feb 19;73(6):717-726. 10.1016/j.jacc.2018.11.035. Erratum in: Nov 26;74(21):2709-2711. 30765038. DISCLOSURES: No relevant relationships James Bradley, source=Web Response Harsimran Brar, William Smith,