Lyme Disease and Heart Disease – Recognizing Lyme Carditis

by lmatthews on April 23, 2012

Avoiding tick hotspots reduces the risk of Lyme disease and runners' pulse monitors could provide an early Lyme Carditis alert!

Lyme carditis is a disease of the heart but early signs of heart problems are not often associated with an infection such as borreliosis and so the condition can easily be overlooked. Carditis means inflammation of the heart, in comparison to cardiomegaly, which is enlargement of the heart; the former condition is generally acute whereas the latter usually takes some time to develop and is often a result of a circulatory issue causing the heart to grow in an effort to compensate for dysfunction elsewhere.

Lyme carditis is a heart problem that is usually fully treatable and leaves no lasting damage if caught early enough. Long-standing inflammation in the heart can cause permanent tissue damage however and ongoing heart problems may result from Lyme disease whether treated or untreated.

How Do You Get Heart Disease with Lyme Disease Infection?

It is not necessarily the case that those with an existing heart condition will succumb to symptoms of Lyme disease centered on the heart; many experiencing Lyme disease heart problems have no prior cardiac dysfunction and no persistent problems after treatment for the infection. However, there is a danger that those who do already suffer from symptoms of heart disease, such as shortness of breath, chest pains, fatigue, and palpitations, could simply ignore these early signs of Lyme carditis or that their physician may dismiss them as part of their existing heart condition. Any symptom exacerbation, or the occurrence of new symptoms, should be brought to the attention of a qualified physician for assessment.

Symptoms of Lyme Carditis

As well as those symptoms of heart disease mentioned above, Lyme carditis symptoms can include faintness, throbbing in the neck, dizziness, dyspnea, syncope, and breathing difficulties when lying down or sleeping. Feverishness and other signs of infection may or may not be present and patients may recall a recent bout of a flu-like illness, a Lyme disease rash, and also be experiencing other symptoms of Lyme disease such as arthritis in one or more large joints, such as the knees. The symptoms of Lyme carditis are caused by the bacterial infection compromising the electrical signalling in the heart, creating an abnormal heart rate which shows up on an electrocardiogram.

Testing for Lyme Disease Heart Problems

lyme disease heart disease lyme carditis atrioventricular heart block

An abnormal heart rhythm can indicate Lyme Carditis.

Patients with symptoms of heart disease will likely undergo a test to assess the electrical signalling of their heart and the regulation of their heart rate. This electocardiogram may show an atrioventricular heart block which means that the four chambers of the heart are not communicating correctly in order to manage the valves and the emptying and filling of the sections of the heart. The degree to which this pump process is disrupted can vary enormously between patients and some estimate that one in ten patients with Lyme disease has some sort of cardiovascular disruption due to the infection, although many are undiagnosed as physicians lack experience in recognizing the symptoms, particularly as heart disease is common in the general population. Lupus may also result in symptoms such as atrioventricular block and can further confuse diagnosis.

Treating Heart Disease from Lyme Disease

Lyme carditis is the result of infection with Borrelia burgdorferi and so the treatment is a two to four week course of an antibiotic such as doxycycline. Serious cases of atrioventricular heart block can necessitate hospitalization, intravenous antibiotics, and even a pacemaker to provide temporary assistance in regulating the heart as the infection is fought. Around a third of patients with Lyme carditis require such a pacemaker although almost all of these have no need of the medical device after the Lyme disease infection has been eradicated. As many Lyme disease infections are thought to remain unrecognized and, therefore, often untreated it is possible that fatal cases of Lyme carditis occur without anyone realizing, particularly in those with pre-existing heart disease. Autopsies may reveal the presence of bacteria in the heart tissue but it is difficult to surmise the contribution of such bacterial infection to the cause of death in some patients and so Lyme disease deaths from heart disease may be underreported.

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