MODERN APPROACHES TO DIAGNOSTICS AND TREATMENT OF CARDIAC LESIONS IN LYME BORRELIOSIS

Abstract

SUMMARY. Modern trends of Lyme borreliosis (LB) diagnostics and treatment are discussed in the article. The main principles of the disease recognition and treatment are considered, as well as diagnostic capability of instrumental and laboratory research methods proposed by clinical protocols.

The diagnosis of Lime carditis (LC) is based on both serological tests results and data confirming the carditis itself. Diagnostic problems relate to non-specificity of LC manifestations and the late onset of symptoms, which makes sometimes difficult to associate heart damage with LB. For this, a risk stratification tool is used – Suspicious Index in LC (SILC). Unlike the early stage of the disease, the role of Borrelia infection in cardiac disorders development in the chronic LB has not been fully studied, therefore there are no criteria for LC in this phase of the disease.

Although schemes for the etiotropic therapy of Lyme disease are developed in detail, they are based on the treatment results in general cohort of patients with LB; studying the antibiotic therapy effectiveness in a cohort of individuals with LC is still a prospect for further research. Clinical guidelines for etiotropic treatment continue to improve, with some differences in recent clinical protocols.There is a need to investigate antibacterial therapy effectiveness in a cohort of patients with heart lesions and LB. The appropriate management of impaired atrioventricular conduction in LB is very important, clinical recommendations include the earliest start of antibiotic therapy, constant ECG monitoring and a temporary pacemaker implantation in case of high-degree block. At the same time, recommendations for treatment of other pathological conditions in LC need further development.