Q: 34 years old female, diagnosed with Lyme's disease 2 weeks ago, is now in the local rural ED of Wisconsin with a syncopal episode. EKG showed a third-degree AV block. ED physician inserted a temporary pacemaker and transferred patient to the tertiary care center. Cardiology is consulted in CCU. Cardiology service should strongly consider the insertion of a permanent pacemaker?
A) True
B) False
Answer: B
Atrioventricular (AV) block due to Lyme disease is typically short-lived and does not require a permanent pacemaker. In most cases, antimicrobial therapy is sufficient in Lyme carditis, but patients who develop syncope, dyspnea, or chest pain or have second- or third-degree atrioventricular block, or a marked prolonged PR interval, or any arrhythmias may require a temporary pacemaker. The choice of antibiotics includes doxycycline, amoxicillin, or cefuroxime.
#cardiology
#ID
References:
1. Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. Clin Infect Dis 2021; 72:e1.
2. Lórincz I, Lakos A, Kovács P, et al. Temporary pacing in complete heart block due to Lyme disease: a case report. Pacing Clin Electrophysiol 1989; 12:1433.
No comments:
Post a Comment