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Case Reports in Cardiology
Volume 2017, Article ID 9157625, 3 pages
Case Report

Lyme Carditis Buried Beneath ST-Segment Elevations

1Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
2Division of General Internal Medicine, Section of Hospital Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

Correspondence should be addressed to Basia Michalski; ude.wcm@ikslahcimb

Received 23 March 2017; Accepted 29 May 2017; Published 21 June 2017

Academic Editor: Monvadi Barbara Srichai

Copyright © 2017 Basia Michalski and Adrian Umpierrez De Reguero. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Lyme disease is caused by the spirochete Borrelia burgdorferi and is carried to human hosts by infected ticks. There are nearly 30,000 cases of Lyme disease reported to the CDC each year, with 3-4% of those cases reporting Lyme carditis. The most common manifestation of Lyme carditis is partial heart block following bacterial-induced inflammation of the conducting nodes. Here we report a 45-year-old gentleman that presented to the hospital with intense nonradiating chest pressure and tightness. Lab studies were remarkable for elevated troponins. EKG demonstrated normal sinus rhythm with mild ST elevations. Three weeks prior to hospital presentation, patient had gone hunting near Madison. One week prior to admission, he noticed an erythematous lesion on his right shoulder. Because of his constellation of history, arthralgias, and carditis, he was started on ceftriaxone to treat probable Lyme disease. This case illustrates the importance of thorough history taking and extensive physical examination when assessing a case of possible acute myocardial infarction. Because Lyme carditis is reversible, recognition of this syndrome in young patients, whether in the form of AV block, myocarditis, or acute myocardial ischemia, is critical to the initiation of appropriate antibiotics in order to prevent permanent heart block, or even death.