Third-Degree Atrioventricular Block as the Initial Presentation of Lyme Disease

Lyme disease is a multisystemic infection that can present as localized disease, early disseminated, or late disease. During the early disseminated phase of Lyme disease, the hematogenous spread can result in extracutaneous manifestations, including cardiac, neurological, and joint. Lyme carditis is an uncommon manifestation occurring in patients with untreated Lyme disease. Third-degree atrioventricular (AV) block is a rarer entity. We present a case of a 21-year-old female with no significant past medical history admitted with third-degree AV block and thereby highlighting this uncommon presentation.