Pereverzeva KG, Yakushin SS. Lyme carditis with pericarditis: A review of clinical cases. World J Cardiol 2026; 18(7): 121524 [DOI: 10.4330/wjc.121524]
Corresponding Author of This Article
Sergey S Yakushin, MD, PhD, Professor, Department of Hospital Therapy, Course of Medical and Social Expertise, Ryazan State Medical University, Ministry of Health of the Russian Federation, 96 Stroykova Street, Ryazan 390026, Russia. s.yakushin@rzgmu.ru
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
review-article
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Jul 26, 2026; 18(7): 121524 Published online Jul 26, 2026. doi: 10.4330/wjc.121524
Lyme carditis with pericarditis: A review of clinical cases
Kristina G Pereverzeva, Sergey S Yakushin
Kristina G Pereverzeva, Sergey S Yakushin, Department of Hospital Therapy, Course of Medical and Social Expertise, Ryazan State Medical University, Ministry of Health of the Russian Federation, Ryazan 390026, Russia
Author contributions: Pereverzeva KG and Yakushin SS performed the study conceptualization, methodology; Pereverzeva KG contributed to the data curation, drafting of the manuscript and editing of the subsequent versions; Yakushin SS provided critical resources, contributed to the reviewing and editing of the various manuscript versions, performed supervision of the project, and performed project administration.
AI contribution statement: Portions of this manuscript were edited using the DeepSeek-V3 AI tool for language refinement. The authors were responsible and agree to accountability for all scientific content. Subsequently, the manuscript was subjected to copyediting by a native English speaker.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Sergey S Yakushin, MD, PhD, Professor, Department of Hospital Therapy, Course of Medical and Social Expertise, Ryazan State Medical University, Ministry of Health of the Russian Federation, 96 Stroykova Street, Ryazan 390026, Russia. s.yakushin@rzgmu.ru
Received: March 26, 2026 Revised: May 22, 2026 Accepted: June 8, 2026 Published online: July 26, 2026 Processing time: 113 Days and 19.6 Hours
Abstract
Pericardial involvement in Lyme carditis is rare, and its clinical spectrum and outcomes are not systematized. To summaries knowledge on epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment of pericardial involvement in Lyme carditis. Narrative literature review in PubMed and Scopus (up to 2025). Documented cases of pericarditis, myopericarditis, and pericardial effusion with Lyme disease were selected. Descriptive analysis identified fifteen cases. Among 15 cases, sex known in 13:11 men (84.6%), 2 women (15.4%). Mean age 43.5 years. Pericarditis without effusion: 46.7%; with effusion without tamponade: 33.3%; with tamponade: 20.0%. Electrocardiogram data in 11 cases: Diffuse ST elevations (36.4%), localized ST elevations mimicking myocardial infarction (18.2%). Serological confirmation in 66.7%, direct Borrelia burgdorferi detection in 13.3%. Antibiotic therapy (ceftriaxone, doxycycline, penicillin) in 86.7%; complete recovery in 93.3%. One fatal outcome due to delayed diagnosis. Pericardial manifestations in Lyme carditis are rare but can be severe (tamponade) and not always accompanied by conduction disturbances. Diagnosis is based on clinical signs in endemic regions, echocardiography, and serology; timely antibiotic therapy is effective. Clinicians should consider Lyme disease in unexplained pericarditis, especially in young patients with systemic symptoms.
Core Tip: Pericardial involvement in Lyme carditis is rare but can range from asymptomatic effusion to tamponade. This review of 15 documented cases highlights that electrocardiogram changes may mimic myocardial infarction, serological confirmation is key, and timely antibiotic therapy leads to favorable outcomes. Clinicians in endemic regions should consider Lyme disease in unexplained pericarditis, especially in young patients.
