Both bartonellosis and Lyme disease are associated with dangerous heart conditions that can be fatal in some cases. The heart has three important aspects that can be affected by disease: electrical, structural, and muscular. Bartonella and Borrelia species can negatively impact all three of these.
The electrical function of the heart causes the muscles to contract in a specific sequence for ideal blood flow. These electrical patterns can be seen on an ECG (electrocardiogram) tracing. Specific pathways carry electrical impulses at different speeds to cause the heart to beat correctly. If an impulse is too fast or too slow, the heart will beat inefficiently, which may be fatal.
Carditis is a localized or diffuse swelling of the heart tissues. It can disrupt electrical signals in the heart, causing a “heart block.” An example of this is when the signal from the atrioventricular node (AV node) is interrupted. Less commonly, a patient may also experience atrial fibrillation, an abnormal heartbeat that can reduce the amount of blood moving through the heart.
A heart block can be detected as an abnormality on an ECG. A severe heart block can prevent the heart from getting the electrical stimulation necessary to beat, leading to sudden death.
Heart blocks can be treated with a pacemaker. It is important to know if the heart block is caused by Lyme carditis. If it is, the patient can use a temporary pacemaker until the carditis is resolved with antibiotic treatment eliminating the need for a permanent pacemaker.
Since these slow heartbeats are the most common result of infection, fast heartbeats can be missed as a symptom of infection. Nevertheless, different kinds of fast electrical impulses like tachycardia and premature ventricular contractions (PVCs) can also be caused by infections.
The structure of the heart valves consists of fibrous material and collagen with very little blood supply into the tissue. Healthy valves allow blood to flow through the chambers of the heart while preventing backward flow. The cells in heart valves are extremely slow-growing and slow-dividing. Consequently, valves are unable to heal the way other tissue does and are susceptible to infection.
Abnormalities in heart valves can increase the risk of infection. About one in fifty people have abnormalities in how their valves developed in gestation. As people age, their valves can develop additional abnormalities, including calcification. Genetic differences such as Ehlers-Danlos syndrome (EDS) can also make valves more likely to deteriorate over time.
Endocarditis is a swelling of the inner layer of the heart. It is often caused by a pathogen that can strike these vulnerable structures. Sometimes inflammation from the pathogen causes fibrin and other materials in the blood to stick to the heart valves. As more of this material sticks together, it grows in the shape of a plant off of the heart valve. The growth is called a “vegetation” because of this shape.
If someone has endocarditis, blood samples will be taken to see if the pathogen can be identified. If no pathogen is identified, the diagnosis is “culture-negative endocarditis.” A common cause of culture-negative endocarditis in humans and animals is Bartonella species infection. A recently published case described a 28-year old patient with a history of homelessness who was positive for Bartonella quintana using PCR. Bartonella quintana is transmitted to humans via lice and is the most common species associated with culture-negative endocarditis, but B. henselae, B. kohlerae, and other species have been implicated in these cases as well.
Rarely, Borrelia species including the species that causes Lyme disease can cause endocarditis. This is most likely because Borrelia typically do not remain in the bloodstream long after infection occurs. Likewise, research shows that Bartonella can cycle in and out of the bloodstream over the course of an infection. If endocarditis causes damage to the heart valves, the patient may require heart valve surgery.
The muscles of the heart contract to move blood through the chambers of the heart. These muscles have a rich blood supply. Over time, the blood vessels supplying the heart can become damaged. Each time a blood vessel is damaged, the body makes a kind of band-aid for the damage out of cholesterol and fibrin. Eventually these build up into plaques which can block blood supply to the heart. This process is called coronary artery disease (CAD).
Rarely, Lyme disease and Bartonella species infections affect the muscle of the heart directly. This can cause angina (heart pain) and damage like a heart attack. When the muscle is damaged, it releases chemicals that can be tested for in the blood. Usually heart muscle damage is caused by CAD. However, with Lyme disease, the test may be positive even though there is no problem with blood flow. In one small study, patients who were assumed to have CAD were tested for several infectious diseases; a number of them had Borrelia species infections, including Lyme disease.
Inflammation from the immune response to infectious disease can increase the cycle of damage to the heart vessels that is repaired with even more aggressive plaques, leading to earlier and more severe CAD than a person otherwise would have had. Despite this logical cause of disease, research on the association of CAD with Lyme disease or Bartonella species infections has had mixed results. It may be that the association between infectious disease and CAD involves additional variables that are unknown at this time.
Bartonellosis and Lyme disease can damage the heart in a variety of ways. Some of this damage may be permanent or require surgery. When a heart problem develops, it is important to consider infectious causes including bartonellosis and Lyme disease so that antibiotic treatment can be initiated and further damage or death can be prevented.
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Great article; however, a reminder that nobody’s really got a bead on how many with Lyme/MSIDS have heart issues. When testing misses over half of all cases with mainstream medicine’s head in the sand, there are many with heart issues flying under the radar or blamed on something else.
Please note that the article states the importance of knowing if the heart issues ARE caused by Lyme/MSIDS as proper treatment will often ameliorate the problem. This is true with nearly every other symptom as well. Knowing is everything but mainstream medicine at this point in time would rather diagnose you with anything BUT Lyme/MSIDS so you need to see ILADS trained health professionals. I could pull up 100 articles of people who went to doctor after doctor only to be misdiagnosed for years that had an underlying Lyme/MSIDS infection that could have been treated. Due to the delay, many never retrieved their health back.
Diagnosing Lyme/MSIDS requires a shift in thinking that mainstream doctors haven’t been wiling to make. Plus, we do not fit into a 10 minute Western Medicine managed care paradigm.
LET’S SUFFICE IT TO SAY, HEART ISSUES WITH TICK BORNE ILLNESS IS NOT RARE.