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Lyme carditis: Things can get complicated when Lyme disease affects heart function

0 3 years ago

Approximately five to 10 per cent of patients presenting to family doctors’ clinics or emergency departments with symptoms of Lyme disease may develop Lyme carditis. The prevalence of Lyme disease in Canada continues to increase year after year. Nearly 2,700 people were diagnosed with Lyme disease in 2019, but the number of reported cases may not reflect the actual number of cases.

How Lyme carditis affects the heart

Lyme carditis most commonly manifests as high-degree atrioventricular block: a complete shut-down of the electrical system of the heart that can evolve rapidly over minutes, hours or days, producing severe symptoms like fainting, extreme dizziness or sudden death.

Less frequently, other serious cardiovascular manifestations may be present, such as:

  • sinus node disease, marked by alterations to the heart’s “motor” or natural pacemaker,
  • atrial fibrillation, which is a disorganization of the cardiac rhythm that increases the risk of stroke,
  • bundle branch blocks, or lesions in the distal cables of the heart that can interrupt electrical impulses, and
  • myocarditis, pericarditis or endocarditis, which are different degrees of inflammation of the layers of the cardiac walls.

Some of these manifestations can be so severe that total cardiac dysfunction may rapidly occur, and the patient may die despite medical efforts. Sometimes a heart transplant is the only option.

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