A Childhood Illness … in an Adult

Navaravong et al present the case of a 43-year-old man with asymptomatic bradycardia. The patient has a normal heart structure and function. His ECG and exercise test findings were compatible with atrioventricular nodal block. Although the differential diagnosis included Lyme carditis, he had a negative Lyme titer, which is highly predictive against early disseminated disease, including Lyme carditis. These findings convinced show that the patient was exhibiting a late presentation of congenital complete heart block rather than acquired complete heart block due to Lyme disease.