Diagnosis and Treatment of Lyme Carditis

Journal of the American College of Cardiology

JACC Review Topic of the Week
Cynthia Yeung and Adrian Baranchuk

Abstract

The incidence of Lyme disease, a tick-borne bacterial infection, is dramatically increasing in North America. The diagnosis of Lyme carditis (LC), an early disseminated manifestation of Lyme disease, has important implications for patient management and preventing further extracutaneous complications. High-degree atrioventricular block is the most common presentation of LC, and usually resolves with antibiotic therapy. A systematic approach to the diagnosis of LC in patients with high-degree atrioventricular block will facilitate the identification of this usually transient condition, thus preventing unnecessary implantation of permanent pacemakers in otherwise healthy young individuals.

__________________

**Comment**

Heart issues with Lyme/MSIDS can cause death.  I would argue that it is not solely an early disseminated manifestation and due to length of illness and involvement of other pathogens, I would also argue against the statement that antibiotic therapy usually resolves it.  At this point nobody’s keeping score of the myriad of patients flying under the radar due to poor testing and misdiagnosis not only for Lyme but for carditis due to Lyme:  https://madisonarealymesupportgroup.com/2018/09/17/lyme-carditis-heart-block-other-complications-of-ld/  In this link CDC expert Dr. Forrester comments that 4-10% of Lyme patients get carditis.  If we take the CDC’s estimate that 300,000 people contract Lyme each year, that’s 12,000 –  30,000 with Lyme carditis.  

Does that sound rare to you?

In contrast, remember the media bliz on Zika? (Mosquitoes here can’t even carry it)

https://madisonarealymesupportgroup.com/2018/06/03/heart-problems-tick-borne-disease/  There are many tick borne illnesses besides Lyme that can cause carditis. An Ontario heart specialist is warning doctors to look for it as numerous people with heart symptoms were admitted to the ER two to three times before anyone even considered it. He also states many don’t get the bullseye rash or notice vague symptoms of fever and muscle aches.

This research shows natural autoantibodies being present in the pericardial fluid with significant correlation of mycoplasma, Lyme, and chlamydia antibodies in patients with heart disease:  https://madisonarealymesupportgroup.com/2018/04/04/correlation-of-natural-autoantibodies-heart-disease-related-antibacterial-antibodies-in-pericardial-fluid-mycoplasma-bb-chlamydia/

This research is linking Ticks to heart disease:  https://madisonarealymesupportgroup.com/2018/07/02/new-uva-study-tentatively-links-ticks-to-heart-disease/

https://madisonarealymesupportgroup.com/2018/07/09/with-unexpected-death-autopsies-should-look-for-lyme-carditis/  Excerpt:  “Lyme expert Dr. Daniel Cameron has done a nice job of summarizing five cases in a blog. http://danielcameronmd.com/autopsy-study-reviews-cases-due-to-sudden-cardiac-death-from-lyme-disease/
Cardiac Tropism of Borrelia burgdorferi: An Autopsy Study of Sudden Cardiac Death Associated with Lyme Carditis. (March 2016)
http://ajp.amjpathol.org/article/S0002-9440(16)00099-7/abstract
Excerpt:

Fatal Lyme carditis caused by the spirochete Borrelia burgdorferi rarely is identified. Here, we describe the pathologic, immunohistochemical, and molecular findings of five case patients.”

THERE IS A WORLD OF DIFFERENCE BETWEEN SOMETHING BEING RARELY IDENTIFIED AND SOMETHING BEING RARE.

https://madisonarealymesupportgroup.com/2018/08/14/vermont-resident-dies-of-rare-lyme-disease-complication-that-isnt-rare/

https://madisonarealymesupportgroup.com/2018/07/09/with-unexpected-death-autopsies-should-look-for-lyme-carditis/

For doctors willing to learn:  https://www.lymecme.info   In this link is a FREE CME course on Lyme Carditis:  Lyme Carditis, More Than Skipped Beats.

Dr. Maloney began providing accredited continuing medical education courses on Lyme disease for physicians in 2007 and continues to do so. She has also developed similar education for nurses and mental health providers. She has published several papers in peer-reviewed medical journals and is frequently invited to speak to medical professionals across the US. She has served as a consultant to private organizations and government agencies in the US and Canada. In February 2018 she was selected to serve on the Pathogenesis, Transmission and Treatment subcommittee of the federally mandated Tick-borne Disease Working Group. Additionally, she recently accepted an invitation to serve on a peer review committee for the Canadian Institutes of Health Research. 

Dr. Betty will be at the upcoming Wisconsin Lyme Conference:  https://madisonarealymesupportgroup.files.wordpress.com/2019/02/at_a_glance-february_2019.pdf