Differential Diagnosis for Cardiac Arrest in a Healthy, Young Active Male with a History of Lyme
- Single most likely diagnosis:
- Lyme carditis: This is a well-known complication of Lyme disease, which can cause cardiac conduction abnormalities, including heart block, and potentially lead to cardiac arrest. The patient's history of Lyme disease makes this a highly plausible diagnosis.
- Other Likely diagnoses:
- Hypertrophic cardiomyopathy: This is a common cause of sudden cardiac death in young athletes. Although the patient is described as healthy, hypertrophic cardiomyopathy can be asymptomatic until a catastrophic event occurs.
- Arrhythmogenic right ventricular cardiomyopathy (ARVC): Another condition that can lead to sudden cardiac death, especially in young, active individuals. It may not have been previously diagnosed.
- Coronary artery anomalies: These are congenital abnormalities of the coronary arteries that can increase the risk of cardiac arrest during intense physical activity.
- Do Not Miss diagnoses:
- Pulmonary embolism: Although less common in young, healthy individuals, a pulmonary embolism can cause cardiac arrest and must be considered, especially if there are any risk factors for thromboembolism.
- Aortic dissection: This is a life-threatening condition that requires immediate diagnosis and treatment. It can present with sudden onset of chest pain and can lead to cardiac arrest.
- Commotio cordis: A blunt trauma to the chest that can cause cardiac arrest, often in the context of sports activities.
- Rare diagnoses:
- Brugada syndrome: A genetic disorder that affects the heart's electrical system and can lead to life-threatening arrhythmias.
- Catecholaminergic polymorphic ventricular tachycardia (CPVT): A rare genetic disorder that can cause sudden cardiac death, especially during physical activity or emotional stress.
- Myocarditis from other causes: While Lyme carditis is a consideration, myocarditis from viral or other bacterial infections could also lead to cardiac arrest in a young, otherwise healthy individual.