Can Lyme Disease Cause Heart Palpitations? Signs of Lyme Carditis to Know
Heart palpitations in a Lyme patient?
It could be Lyme carditis—a complication that affects the heart’s rhythm.
Heart palpitations can be an early sign of Lyme carditis—a potentially serious complication of Lyme disease.
Yes—Lyme disease can cause heart palpitations. In some cases, the infection affects the heart’s electrical system, leading to abnormal rhythms, pauses, or a slow heart rate.
Lyme Disease Heart Symptoms
Lyme disease can affect the heart and lead to a range of cardiac symptoms, including:
- Heart palpitations
- Chest discomfort
- Shortness of breath
- Dizziness or fainting
- Fatigue
Patients may also experience a wide range of Lyme symptoms that evolve over time.
Lyme carditis occurs in a small percentage of Lyme disease cases, but it can be serious when it affects the heart’s electrical system.
Why Lyme Disease Can Cause Palpitations
Lyme disease can interfere with the heart’s electrical conduction system, leading to rhythm disturbances such as heart block or sinus node dysfunction.
These conduction abnormalities may cause palpitations, skipped beats, or episodes of a slow or irregular heart rate.
What Is Lyme Carditis?
Lyme carditis occurs when the bacteria causing Lyme disease affect the heart tissue, particularly the electrical conduction system.
This can result in conduction abnormalities, including heart block, or less commonly, sinus node dysfunction.
Case: Lyme Carditis Causing Palpitations
This case shows how Lyme carditis may present primarily with palpitations—even when imaging studies are normal.
The case involved a 46-year-old man with Lyme disease who presented with cardiac complications, initially manifesting as palpitations.
He lived in a Lyme endemic region and reported a “pinching sensation in his right thigh with an associated macular erythematous rash,” according to the authors. He did not notice a tick bite.
The man later developed high fevers, fatigue, and a second rash on the upper left part of his body.
Lyme disease testing was positive for IgG and IgM titers.
He had initially started cephalexin at home and was subsequently prescribed a 2-week course of doxycycline.
During the second week of antibiotic therapy, he developed palpitations and an uneasy feeling in his chest, particularly after exercise.
Cardiac MRI findings were normal, but a mobile electrocardiogram (ECG) detected sinus pauses with both wide and narrow complex escape rhythms.
Further testing revealed sinus bradycardia. He was treated with intravenous ceftriaxone.
He was diagnosed with partially treated early disseminated Lyme disease, considered to be the cause of his sinoatrial nodal dysfunction.
The patient’s cardiac complications resolved after appropriate treatment.
Why Lyme Carditis Can Be Missed
Lyme carditis may be overlooked because symptoms can appear after starting treatment and standard imaging, such as cardiac MRI, may be normal.
In this case, rhythm abnormalities were detected through monitoring rather than imaging.
Lyme carditis can present with palpitations even when routine cardiac testing appears normal.
FAQ: Lyme Disease and Heart Palpitations
Can Lyme disease cause heart palpitations?
Yes. Lyme disease can affect the heart’s electrical system and lead to palpitations or irregular rhythms.
Are palpitations from Lyme disease dangerous?
They can be. In some cases, Lyme carditis may lead to heart block or other serious rhythm problems.
Clinical Takeaway
Lyme disease should be considered in patients with unexplained heart palpitations, especially in those living in endemic areas or with a history of rash or flu-like symptoms.
Early recognition of Lyme carditis can prevent serious cardiac complications.
Start here:
Lyme symptoms guide |
Why Lyme tests can be negative |
Coinfections overview
References
- Chen B, Krumerman A. Lyme carditis–induced sinoatrial dysfunction after initiation of targeted oral antibiotic therapy: A case report. HeartRhythm Case Reports. 2023. https://doi.org/10.1016/j.hrcr.2023.07.017
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
I am curious if a Lyme carditis patient that still exhibits an asymptomatic first degree right bundle branch block years after IV Rocephin treatment has any increased risk of cardiac events? Does the continued presentation of RBBB indicate continued presence of infection despite resolution of acute illness reflected by normalization of IgM antibodies confirmed by highly sensitive Western blot?
I got bit by 3 different ticks within 24 hours. A couple of days later I started running a low grade fever. 100.1 and my back pain was unbearable. 3 months later still running 99.6 temp every day.My heart rate was 151. Put me on a beta blocker then doubled it when it went back up to 127. Will it ever go back down to normal?
A persistent elevated heart rate after tick bites deserves a careful evaluation for an underlying cause. In my practice, I also consider autonomic dysfunction as part of the evaluation, particularly when patients develop symptoms such as tachycardia, temperature dysregulation, dizziness, fatigue, or exercise intolerance following a tick-borne illness.