Lyme carditis: Persistent local delayed enhancement by cardiac magnetic resonance imaging

Lyme borreliosis (LB) is the most common tick-born disease in the Northern Hemisphere. During early disseminated Lyme disease cardiac manifestation can occur. We report a case of isolated Lyme myocarditis with transitory total atrioventricular (AV)-block and myocardial necrosis indicated by a rise in Troponin-T (TNT). Antibiotic treatment resulted in complete resolution of the AV-block, but a local epimyocardial contrast enhancement persisted as shown by cardiac magnetic resonance imaging (MRI).