When Lyme disease mimics a heart attack

Lyme disease has earned a reputation as the great imitator, because its symptoms can mimic many other illnesses. In a case report, presented by Gilson and colleagues from Easton Hospital in Pennsylvania, a 45-year-old woman was believed to be suffering from a heart attack when, in fact, her symptoms were due to Lyme disease. [1]

 

According to the authors, Lyme disease mimicked a myocardial infarction (heart attack)  in a 45-year-old woman who presented with a sudden onset of chest pain, radiating to her neck. The evidence supporting a diagnosis of myocardial infarction was strong. A medical workup showed the woman had EKG changes, high admission levels of Troponin and CK-MB, and rising Troponin and CK-MB at 6 hours. Fortunately, the woman’s cardiac catheterization did not show any significant obstructive coronary artery disease.

She was diagnosed with Lyme disease 2 days later after she had developed a right-sided facial palsy. The diagnosis was confirmed by ELISA and positive IgM and IgG antibodies.

Treatment was successful with a combination of intravenous ceftriaxone and oral steroids.

“This is a rare case of Lyme myocarditis associated with markedly elevated Troponin I, normal left ventricle function, and an absence of conduction abnormalities,” writes Gilson.

The authors point out the difficulties diagnosing atypical manifestations of Lyme disease, stating, “Lyme myocarditis may be a challenging diagnosis in endemic areas especially in patients with coronary artery disease risk factors, presenting with typical chest pain, EKG changes and positive cardiac biomarkers.”

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The authors reminded doctors of the need to include Lyme disease in the differential diagnosis even in patients presenting with clinical symptoms suggestive of acute coronary syndrome.

Related Articles:

Lyme carditis causes complete heart block in 26-year-old man

12-year-old boy suffers cardiac arrest due to Lyme disease

What might sudden cardiac death due to Lyme disease look like?

References:

  1. Gilson J, Khalighi K, Elmi F, Krishnamurthy M, Talebian A, Toor RS. Lyme disease presenting with facial palsy and myocarditis mimicking myocardial infarction. J Community Hosp Intern Med Perspect. 2017;7(6):363-365.


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MichaelMVP ResourceKaytLiving With MVPDr. Daniel Cameron Recent comment authors
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MVP Resource
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It’s interesting how other diseases/illnesses can mimic a heart attack and cause the same symptoms. Some of these aren’t even necessarily dangerous. With mitral valve prolapse, for example, chest pain/angina is common, as are symptoms such as shortness of breath, fatigue, dizziness, etc. Thing is, one never knows, so it’s important to not brush off new/scary symptoms or wait it out.

Kayt
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Kayt

I’ve had Lyme, Rocky Mountain Spotted Fever, Babesia, and Bartonella for 4 years now and I still get intermittent chest pains like a heart attack. Had a full cardiology work up when I was first sick but not yet diagnosed, everything looked wonderful. A couple years in I started getting race heart rates, low bp, and fainting episodes. A few EKGs came back abnormal, but would then resolve once at the hospital. My LLMD and PCP suspect POTs, I do have significant neurological disruption (left side of body feels slightly disconnected compared to the right, my pulse has also been… Read more »

Living With MVP
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Pretty scary stuff 🙁
Hope the women is now ok though!

Rosemarie
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Rosemarie

Chest pain is so scary. I’ve been to 3 cardiologists and one electrophysiologist and they’ve all cleared me for heart problems. I just hate feeling like they’re missing something. I guess I just have to trust their judgement and the evidence the tests and multiple labs presents. Not sure why I have sharp bursts of chest pain other than lyme disease and co-infections. I absolutley never had palpitations, chest pain or shortness of breath before. Got sick last July and these symptoms began. I am glad I got checked out, both for cardiac and pulmonary issues. I just wish the… Read more »

Robert Rose
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I had a tick bite 8 months ago with a cascading rash. I started having a host of symptoms (swollen lymph nodes, left side facial insensitivity including the tongue, tingling in the arms, legs, and back of the head. I have a low body temp 97.5 and had terrible flu like symptoms. I was tested (Quest labs) using Western blot and was negative. I am an avid runner but started having minor chest pains (left side) that have progressively gotten more constant. They do not worsen with exercise. I received an MRI on brain which was negative. I have had… Read more »

Michael
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Michael

Hi Robert, I was wondering if your symptoms went away? Everything sounds very similar to what I have and I am a runner too. It started as a minor chest pain (left side) and slowly spread to a pretty bad shoulder and neck pain that gets worse at nights. I feel like my muscles on the upper left side got heavy or swollen and push on my nerves and that’s causing pain. It comes along with fatigue and low body temperature. There are good days and bad days. It’s been for 6 months. Quest lab tests for lyme came negative.… Read more »

Christine rogers
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Christine rogers

I Was finally diagnosed with lymes disease after going to the er for chills ,fever neck pain in 2016 by my primary care after the erythema rash developed on my knee several days later. I was placed on doxy for 10 days and all was good. Aug 2 2018 I woke with pain in my left shoulder pain , thought I slept wrong I took some aleeve in the morning went to work and still felt the discomfort. I develvedoped chills and thought am I getting lymes again. I had aches and pain in my upper body., pain when taking… Read more »

Gretchen Bryan
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Gretchen Bryan

This is how my Lyme story started 3+ years ago. I had symptoms of a heart attack, raised troponin levels. All other cardio test came back that as a 50 year old, I had the cardiovascular system of a 35 year old.
I still have some palpitations, but my chest pain and back pain have cleared for the most part. My worst symptom is daily horrendous anxiety, major depression, crying jags. Still very scary for me EVERY DAY. Still in treatment.

Jen
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Jen

Hello, I have had Lyme for over over 10 years it is believed. I did a short course of abx when I found out, now am
On herbal treatment. I had a oil set embolism before beginning the herbal treatment last year. A huge history o unexplained chest pains and tachycardia with a near normal cardiac workup other than some what my doc describes as insignificant ekg changes. They won’t even refer me to cardiology again although my symptoms are much the same and unimproved.

Suzie
Guest

My husband was 59 when he died from Lymes Carditis. All Lymes tests for the month prior were negative. The CDC and Minnesota Department of Public Health confirmed the results after his autopsy.

Pam
Guest
Pam

Just wanted to tell you how sorry I am for the loss of your husband. Everything about this disease is horrible, including the lack of support from doctors and insurance companies, dismissal by the media and consequent ridicule from the public. So grateful to the medical professionals, researchers and patients who work tirelessly to change things for the better. Hoping you have some of those people in your life, and that those relationships provide the love and support you deserve.

Catherine
Guest

PTLDS is a medical term implying that all medical treatment has failed, and that one’s only hope is to seek alternatives outside the medical system. Chronic Lyme Disease, on the other hand, is acknowledgment of a disease process that proceeds Borrelia infection and by nature of tick biology, may include multiple co-infections. Whether by ongoing infection, immune response, unknown factors or a combination of these, people are still sick and treatments still need to be explored. Please stop calling it post treatment.