Lyme Borreliosis as Cause of Myocarditis: A Case Report and a Review of the Literature

lyme borreliosis (LB) is the most common tick-born disease in the Northern Hemisphere. During early disseminated Lyme disease, cardiac manifestation can occur. including acute conduction disorders, atrioventricular block, acute myopericarditis or left ventricular dysfunction and rarely cardiomegaly or fatal pericarditis. We report a case of a patient with isolated Lyme myocarditis manifested by acute heart failure with atrial fibrillation and review of the literature on the subject. The interested of this case report is to show the need to acquire the reflex to think about a lyme carditis when patients in endemic areas come to attention with cardiovasculair symtoms, even in the absence of others concurerenr clinical manifestations of early lyme disease.

Takotsubo syndrome as a cardiac manifestation of multisystem inflammatory syndrome in children

Cases of severe heart damage in patients presenting with multisystem inflammatory syndrome in children are one of the most intriguing phenomena during the coronavirus disease of 2019 pandemic. The pathophysiology of myocardial changes in the course of this syndrome has not been fully understood yet. We present a case of a child with multisystem inflammatory syndrome in children and with cardiac changes corresponding to Takotsubo syndrome.

Study of Cardiac Manifestation in Patients with Seropositive Dengue Fever and to Find Correlation with Subclinical Cardiac Involvement

Objective: The main objective of the present study was to observe the electrocardiogram (ECG) changes in dengue fever and to find correlation with subclinical cardiac involvement. Methods: This was an observational, prospective, non-randomized study. High grade fever for one to five days diagnosed as dengue infection later confirmed by dengue tests (NS1, IgG and IgM ELISA) were included in this study. Prior to the commencement of the study informed consent was taken from all the participants. With 12 lead ECG taken during the febrile phase of dengue fever randomly selected serologically confirmed cases of dengue fever were evaluated at an interval of 24 hrs. for a total of five days. On the day of admission when the patient was afebrile, echocardiography was done. Plasma leakage was diagnosed by presence of any one of four: subcutaneous oedema (pedal oedema, facial puffiness) or pleural effusion or pericardial effusion or ascites. Result: A total 80 patients who were admitted to hospital during study periods due to symptoms of dengue fever and IgM dengue positive status were included in this study. Among this total population of 80 patients (N=80) 48 were male and 32 were female. Out of these, majority were diagnosed as DF 52 (65%), 23 (29%) were diagnosed as DHF and rest only 5 (6%) were diagnosed as DSS. Total 54 patients were found to have normal ECG among which 35 were having dengue fever, 16 were having DHF and 3 were having DSS. Total 2 patients were diagnosed to have left ventricular hypertrophy among which one had dengue fever and rest two had DHF. ST depression was observed in total 7 patients in which 5 were had dengue fever and 2 were had DHF. Relative bradycardia was found in 14, tall t waves in 2 and ventricular ectopics in 1 patient (table 2). Abnormal ECG findings were compared using Chi-square test and were found to be statistically significant (P < 0.05) in dengue fever and DHF. There was statistically significant correlation between ECG abnormalities and abdominal pain and mucosal bleed. The presence of plasma leakage were observed among 77 (96.3%) patients. Proportion of echocardiography abnormalities were higher among patients with plasma leak 6 (30%) as compared to without plasma leak 9 (15%), this difference was not found to be statistically significant Conclusion: In all type of Dengue infections incidence of cardiac involvement was quite high. Due to the overlapping clinical manifestations such as capillary leak associated with DENV infection, tachycardia, pulmonary edema, and hypotension as well as due to the low index of clinical suspicion cardiac involvement in dengue fever is often underdiagnosed. Keywords: Cardiac manifestation, dengue infection, echocardiography, electrocardiography.

Study of cardiac manifestations in hypothyroid patients admitted in tertiary care centre

Background: Hypothyroidism is the most common pathological hormone deficiency. To study various cardiac manifestations in overt and subclinical hypothyroidism.Methods: The cross-sectional analytic study is carried out on 60 patients of hypothyroid subjects in indoor facility of general medicine department in SMIMER hospital.Results: This study shows positive correlation between thyroid stimulating hormone (TSH) level, electrocardiogram (ECG) and echocardiographic findings. In this study, there is female predominance, ECG findings most commonly suggestive of sinus bradycardia and ECHO findings are most commonly suggestive of diastolic dysfunction with pericardial effusion.Conclusions: The early recognition and early initiation of treatment of hypothyroidism may helpful to lowering heart changes as hypothyroidism is reversible cause for cardiac manifestation.

Double-valve Replacement for Aortic and Tricuspid Autoimmune Endocarditis

Libman–Sacks endocarditis (LSE) is a cardiac manifestation of systemic lupus erythematosus and antiphospholipid syndrome and is characterized by non-bacterial verrucous vegetations with thrombogenic potential, causing stenosis and/or regurgitation in left heart predominantly, which can be asymptomatic in most of the cases but in the acute form it may present an infective form (pseudoinfective endocarditis) and complicate diagnosis and treatment. We present a case of aortic and tricuspid valve destruction due to Libman-Sacks endocarditis in a patient with antiphospholipid syndrome requiring surgical treatment by aortic and tricuspid valve replacement.

Novel cardiac manifestation of USH2A and GJB2 genes: A case report

Electrical storm can be caused by structural heart diseases and/or functional electrical abnormalities. We report a young boy without cardiac risk factors, having a positive family history of sudden cardiac death who presented with electrical storm. Stepwise diagnostic approach was not fruitful to determine previously known causes as the origin of the electrical storm. A new genotype related to the current electrical storm has been found, and intracardiac pacing ceased it.

Cardiac Manifestations in Children with SARS-COV-2 Infection: 1-Year Pediatric Multicenter Experience

Since the spread of COVID-19, pediatric patients were initially considered less affected by SARS-COV-2, but current literature reported subsets of children with multisystem inflammatory syndrome (MIS-C). This study aims to describe the cardiac manifestation of SARS-COV-2 infection in a large cohort of children admitted to two Italian pediatric referral centers. Between March 2020 and March 2021, we performed a cardiac evaluation in 294 children (mean age 9 ± 5.9 years, male 60%) with active or previous SARS-COV-2 infection. Twenty-six showed ECG abnormalities: 63 repolarization anomalies, 13 Long QTc, five premature ventricular beats, two non-sustained ventricular tachycardia, and one atrial fibrillation. In total, 146 patients underwent cardiac biomarkers: NT-proBNP was elevated in 57, troponin in 34. An echocardiogram was performed in 98, showing 54 cardiac anomalies: 27 left-ventricular dysfunction, 42 pericarditis, 16 coronaritis. MIS-C was documented in 46 patients (mean age 9 ± 4.8 years, male 61%) with cardiac manifestations in 97.8%: 27 ventricular dysfunctions, 32 pericarditis, 15 coronaritis, 3 arrhythmias. All patients recovered, and during follow-up, no cardiac anomalies were recorded. Our experience showed that cardiac involvement is not rare in children with SARS-COV-2, and occurred in almost all patients with MIS-C. However, patients’ recovery is satisfactory and no additional events were reported during FU.