Case Presentation: Lyme disease a multisystem disease, occurring globally is caused by the spirochete borrelia burgdorferi and transmitted by the Ixodes tick.(6) The incidence of Lyme carditis (LC) is rare with reported incidences of 4%- 10% but recent studies showing 0.3% to 4% with high grade AV block is the most common presentation.(5,2) We present [...]