Lyme Carditis in a Teen: Palpitations and Chest Pain Case
Welcome to another edition of the Inside Lyme Podcast with Dr. Daniel Cameron. In this episode, I discuss a case involving a 16-year-old boy who developed cardiac symptoms including palpitations and chest pain due to Lyme disease. The adolescent was later diagnosed with Lyme carditis.
A 16-year-old male presenting with palpitations and chest pain illustrates how Lyme disease can initially appear as a cardiac condition.
In the journal BMC Infectious Diseases, Myers and colleagues describe a 16-year-old male who presented with palpitations and chest pain. [1] During the physical examination, physicians discovered an erythema migrans rash consistent with Lyme disease.
An electrocardiogram (EKG) revealed a first-degree heart block, leading to the diagnosis of Lyme carditis. Laboratory testing confirmed Lyme disease infection.
Unfortunately, the patient’s heart block progressed during hospitalization. “The hospital course was further remarkable for transition to second-degree heart block and transient episodes of complete heart block,” wrote Myers and colleagues.
When Lyme disease causes cardiac symptoms
The authors emphasize that patients with suspected Lyme carditis and cardiac symptoms should be hospitalized for monitoring and treatment.
“Any patient with suspected Lyme carditis manifesting cardiac symptoms such as syncope, chest pain, or EKG changes should be admitted for parenteral antibiotic therapy and cardiac monitoring.”
Lyme carditis can present in several ways. In addition to heart block, other cardiac manifestations may include myopericarditis, left ventricular dysfunction, and cardiomegaly.
Treatment and recovery
Fortunately, the young patient responded well to treatment. He was treated with intravenous ceftriaxone followed by oral doxycycline.
He remained hospitalized for 10 days and completed a total of 28 days of doxycycline therapy.
The case highlights an important clinical lesson.
Author’s Takeaway: “First, this case illustrates that signs and symptoms of cardiac disease such as palpitations and chest pain may be the chief complaint of patients with Lyme disease in pediatric practice.”
Inside Lyme Podcast Series
This Inside Lyme case series will be discussed on my
Facebook
and made available on podcast platforms and
YouTube.
Your likes, comments, and shares help spread the word about this series and our work. If you can, please leave a review on
iTunes or wherever you get your podcasts.
References
- Myers F, Mishra PE, Cortez D, Schleiss MR. Chest palpitations in a teenager as an unusual presentation of Lyme disease: case report. BMC Infect Dis. 2020;20(1):730.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Is there a post on how we can share this podcast in our Lyme groups? I’m not “getting it” so I think that will be a somewhat common result. Is there an announcement-what is it, Where do we go, how to listen, when?
Thank you for the question. I am blessed to have many helpful comments and questions posted on FaceBook when I publish a blog. I am planning on recording a podcast that will address some of their questions and comments. I am not able to record the podcast live. Instead, I will be posting the podcast on my blog in 2 or 3 days.
When I suffered this lyme carditis, there were skeptical doctors and little answers. I was not believed until I insisted on an echocardiogram which showed fluid around my heart I have never heard of someone else with this condition can I know more?
I have writing on the topic in my blogs, e.g. https://danielcameronmd.com/growing-list-cardiac-problems-lyme-disease/
Hello Dr Cameron I’m a Lyme patient now living in Ghana and very little is known of this disease here the Doctors here only know of it but are completely out of the loop when it comes to treatments etc so o have to maintain my doctor in the US. Was diagnosed with neurological Lyme in 2014 after years of suffering … ii’m doing relatively well now considering experiencing extreme electrosensitivy food and chemical allergies … I’m left with indigestion and food sensitivities which has left me with a limited diet . The covid astra Zeneca is currently being given out here in Gh and I want to take it but I’m also concerned about how my body dt may react considering my allergies etc but I’ll have to weigh the risk here of getting covid or taking the vaccine . I’ve recently almost 2 weeks started taking my herbal meds again as per know Lyme doc due to recurring indigestion and stomach upsets thinks I m
You are asking the same questions we discuss in the USA. The decision is not easy for Lyme disease patients who have faced immune issues related to Lyme disease.