{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:53:27Z","timestamp":1777730007991,"version":"3.51.4"},"reference-count":34,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Background\/Objectives: Lyme disease is a tick-borne zoonosis caused by Borrelia burgdorferi that can affect multiple organ systems. Although cardiovascular involvement is considered uncommon, it may lead to severe and potentially life-threatening complications, particularly conduction disturbances and inflammatory cardiac conditions. This review aims to describe the spectrum of cardiovascular manifestations documented in patients with Lyme disease, focusing on clinical presentation, diagnostic approaches, management strategies, and reported outcomes. Methods: A narrative literature review was performed using PubMed, MEDLINE, and Google Scholar. Articles published between January 2000 and July 2025 in English or Spanish were screened. Eligible studies included original research articles, systematic and narrative reviews, case series, and case reports describing confirmed Lyme disease with cardiovascular involvement. A total of 30 studies were included. The available evidence was predominantly based on case reports and small case series, with considerable heterogeneity in study design, patient populations, and reported outcomes. Data on clinical manifestations, diagnostic methods, treatment strategies, and outcomes were extracted and synthesized. Results: Atrioventricular conduction disturbances were the most frequently reported cardiovascular manifestation, ranging from first-degree block to complete heart block, often presenting abruptly with syncope or bradycardia. Other reported manifestations included atrial and ventricular arrhythmias, myocarditis, pericarditis, myopericarditis, valvular endocarditis, aortitis, and vasculitis. Diagnosis relied on a combination of clinical suspicion, epidemiologic exposure, serologic testing, electrocardiographic monitoring, and cardiac imaging. Most patients were treated with antimicrobial therapy, commonly intravenous ceftriaxone followed by oral doxycycline, with temporary pacemaker support required in selected cases. Overall, clinical outcomes were favorable when treatment was initiated promptly. Conclusions: Cardiovascular involvement in Lyme disease, although infrequent, encompasses a broad clinical spectrum with potentially serious consequences. Early recognition, appropriate diagnostic evaluation, and timely antimicrobial therapy are essential to ensure reversibility of cardiac manifestations and favorable outcomes. However, the available evidence is limited by heterogeneity and the predominance of low-level-evidence studies.<\/jats:p>","DOI":"10.3390\/idr18030040","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:33:37Z","timestamp":1777376017000},"page":"40","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular Manifestations Documented in Patients with Lyme Disease: Clinical Presentation, Management Strategies, and Outcomes"],"prefix":"10.3390","volume":"18","author":[{"given":"Luis Antonio","family":"Cortes Islas","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Epidemiology, Dr. Manuel Gea Gonzalez General Hospital, Calzada de Tlalpan 4800, Belisario Dominguez secc 16, Tlalpan, Mexico City 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscila Mishelle","family":"Bartolo Gomez","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Epidemiology, Dr. Manuel Gea Gonzalez General Hospital, Calzada de Tlalpan 4800, Belisario Dominguez secc 16, Tlalpan, Mexico City 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora Denice","family":"Cuevas Obispo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Epidemiology, Dr. Manuel Gea Gonzalez General Hospital, Calzada de Tlalpan 4800, Belisario Dominguez secc 16, Tlalpan, Mexico City 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayelen","family":"Xicohtencatl Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Division of Basic Research, National Cancer Institute, San Fernando No. 22, Tlalpan, Mexico City 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lao Yuling Lopez","family":"Lucero","sequence":"additional","affiliation":[{"name":"Emergency Division, Dr. Manuel Gea Gonzalez General Hospital, Calzada de Tlalpan 4800, Belisario Dominguez secc 16, Tlalpan, Mexico City 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Pablo","family":"Ramirez Hinojosa","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Epidemiology, Dr. Manuel Gea Gonzalez General Hospital, Calzada de Tlalpan 4800, Belisario Dominguez secc 16, Tlalpan, Mexico City 14080, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e01799","DOI":"10.1016\/j.idcr.2023.e01799","article-title":"Lyme disease presenting as complete heart block in a young man: Case report and review of pathogenesis","volume":"32","author":"Carnazzo","year":"2023","journal-title":"IDCases"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.xjtc.2024.03.023","article-title":"Lyme disease: A rare cause of infective endocarditis","volume":"25","author":"Guilfoose","year":"2024","journal-title":"JTCVS Tech."},{"key":"ref_3","first-page":"e54096","article-title":"Lyme-Associated Pericarditis: A Case Report and Literature Review","volume":"16","author":"Ameer","year":"2024","journal-title":"Cureus"},{"key":"ref_4","first-page":"e11607","article-title":"Jaw Pain and Profound Bradycardia\u2014An Atypical Presentation of Lyme Carditis","volume":"12","author":"Schick","year":"2020","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"726","DOI":"10.3855\/jidc.15071","article-title":"First-degree atrioventricular block in 14-year-old child due to Lyme disease","volume":"16","author":"Lytvyn","year":"2022","journal-title":"J. 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