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.

[bctt tweet=”Lyme disease mimics heart attack.” username=”DrDanielCameron”]

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.”

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?


  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.

31 Replies to "When Lyme disease mimics a heart attack"

  • Todd P
    03/11/2021 (7:40 am)

    @SuMay and @DocCameron – Came across this post as I’ve been diagnosed with Lyme via Igenix (Western blot came back neg of course). Biggest issue by far was I couldn’t seem to take a deep breath for months all of a sudden and had major breathing issues (enhanced when lying down). Added now are chest pains that typically are on the left side near and around my heart in various places. At first I thought it was some sort of heart attack (both jabbing sharp pains and then at times dull ache). Some days now the pain reverberates to the right side as well. @Su – Have your problems with chest pain resolved at all? Were you able to discover anything specific as it relates to the antibiotics and getting rid of the chest pain? @Doc – The part about costochondritis caught my eye as my PT specialist from years past kept saying I had exactly that (costo). Are there any known solutions or ideas on treatment for the chest pain while taking antibiotics for people with costo? Thx

    • Dr. Daniel Cameron
      03/11/2021 (8:13 am)

      I have patients with similar issues despite exhaustive evaluations by cardiologists. I have had some patients who have benefited from treatment for Lyme disease. I have also had patients who have air hunger from Babesia.

  • MVP Resource
    07/18/2019 (8:40 am)

    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
    05/05/2019 (4:17 am)

    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 noted as weaker in my left side, numbness, tingling, burning, shooting, occasional tremors with stress) to add on top of that. There’s also the issue of mold exposure, so trying to narrow it all down before jumping to carditis. Terrifying though, to have all the symptoms of a heart attack and physically feel like you’re dying while the people around you have no clue how to stop it or ease it.

    • John Book
      02/18/2020 (6:00 pm)

      You should also consider speaking with your Physician the Alpha-Gal Mammalian Meat Allergy allergy as possibly being a contributor to your chest pain. After treatment for Lyme Disease, it took 8 years for me to determine that most of my inflammation, respiratory issues and chest pain were directly related to the Alpha Gal Allergy and avoidance of key triggers, including meat, dairy, toothpaste and any products containing carrageenan.

  • Living With MVP
    02/03/2019 (5:14 am)

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

  • Rosemarie
    09/18/2018 (12:00 am)

    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 pain would go away for good.

    • Dr. Daniel Cameron
      09/18/2018 (7:06 pm)

      I am glad you do not have cardiac or pulmonary problems. You will likely have to see other doctors including doctors experienced in Lyme disease to try and find a solution.

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