Can Lyme Disease Cause a Heart Murmur?
HEART SYMPTOMS?
LYME DISEASE
CAN AFFECT THE HEART—RARELY THE VALVES
Yes—Lyme disease can affect the heart and, in rare cases, may lead to a heart murmur.
In some cases, heart symptoms may be one of the first signs of Lyme carditis.
A heart murmur in Lyme disease may result from inflammation affecting the heart valves.
Lyme carditis can involve inflammation of the heart muscle, conduction system, or heart valves.
For a broader overview, see Lyme disease symptoms guide.
How Lyme Disease Affects the Heart
Lyme carditis occurs when the infection spreads to the heart.
- Conduction abnormalities (heart block)
- Arrhythmias
- Myopericarditis
- Left ventricular dysfunction
- Rarely, valvular dysfunction causing a heart murmur
Heart valve involvement in Lyme carditis is rare, with only a small number of reported cases.
Symptoms of Lyme Carditis
- Chest pain
- Lightheadedness or fainting
- Palpitations
- Shortness of breath
- In rare cases, a heart murmur
Case: Mitral Valve Dysfunction From Lyme Carditis
This case highlights how Lyme disease can affect heart valves and lead to abnormal heart function.
A 22-year-old man presented with chest pain, lightheadedness, and a rapid heart rate. He also reported an erythema migrans rash.
Clinicians initially suspected a cardiac event and treated him with intravenous heparin.
An echocardiogram revealed reduced left ventricular function and moderate to severe mitral regurgitation.
Laboratory testing confirmed Lyme disease, and he was treated with intravenous ceftriaxone.
Follow-up imaging showed improvement in valve function and normalization of cardiac function after treatment.
This presentation is consistent with findings described by Malik et al. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8458661/), who reported early Lyme myopericarditis with mitral regurgitation.
Why Lyme Carditis Can Be Missed
- Symptoms may mimic heart attack or other cardiac conditions
- Tick bite or rash may not be recalled
- Cardiac involvement can occur weeks after infection
This can delay diagnosis if Lyme disease is not considered early.
How Common Is Valve Involvement in Lyme Disease?
Valvular dysfunction in Lyme carditis is rare.
Only a small number of cases involving heart valve abnormalities have been reported in the literature.
More commonly, Lyme carditis presents with conduction abnormalities such as heart block.
Can Lyme Carditis Be Serious?
Yes. Although uncommon, untreated Lyme carditis can lead to serious complications.
A case series described by Shen et al. (https://pubmed.ncbi.nlm.nih.gov/33951989/) included patients with severe cardiac involvement, including fatal outcomes.
Prompt diagnosis and treatment are essential.
FAQ: Lyme Disease and Heart Murmurs
Can Lyme disease cause a heart murmur?
Yes. In rare cases, Lyme carditis can affect heart valves and produce a murmur.
What is Lyme carditis?
Lyme carditis occurs when Lyme disease affects the heart, causing inflammation and electrical or structural abnormalities.
Is a heart murmur common in Lyme disease?
No. Murmurs are uncommon and usually related to rare valve involvement.
Can Lyme carditis be serious?
Yes. In rare cases, untreated Lyme carditis can lead to heart failure or sudden cardiac death.
Can Lyme carditis be treated?
Yes. With appropriate antibiotic therapy, most patients improve significantly.
Clinical Takeaway
Lyme disease can affect the heart in multiple ways, including rare involvement of the heart valves.
Recognizing cardiac symptoms early is critical, as untreated Lyme carditis can lead to serious complications.
Prompt diagnosis and treatment typically result in recovery.
Related Articles:
Podcast: Young man dies from Lyme carditis
Lyme carditis diagnosis: 18 cases
Patients can die when Lyme carditis is not treated
References:
- Malik MB, et al. Early Onset Lyme Myopericarditis With Left Ventricular Dysfunction and Mitral Regurgitation. 2021.
- Shen RV, et al. Lyme Carditis Case Series. 2021.
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 this ever been found in patients suffering from LATE stage Lyme disease, I was diagnosed (9/6/2020) with the coinfection Babesia as well and my doctors always assume that it’s just a symptom of that: “air hunger” however I have such horrible chest pain heart palpitations in addition to that….
Yes.
It is also important to rule out other illnesses.
Yes.
It is also important to rule out other illnesses.
I am curious if this ever been found in patients suffering from LATE stage Lyme disease, I was diagnosed (9/6/2020) with the coinfection Babesia as well and my doctors always assume that it’s just a symptom of that: “air hunger” however I have such horrible chest pain heart palpitations in addition to that….
I took the survey, but my list of health issues since contracting lyme is extensive.
I’m reading this wondering if my heart issues are related.
Now also finding several lesions, cysts, ostioma, adenoma, nodules, etc.
Wondering if better treatment might reduce these issues.
Q-fever was never addressed as i was told he didnt know what to do with the results.
Since the possibility of chronic has been updated by the CDC but still not addressed.
Hi there, I have no clue if this will be seen but I have had chronic Lyme for many years now. The last year my cardiac symptoms have worsened and am now being seen my cardiology. So much chest pain, constantly out of breath, etc. I have been diagnosed with SVT and Mobitz Type 1. I had an ECHO yesterday that showed trace mitral and tricuspid valve regurgitation. I just know it is the Lyme – I just started with a LLND and am hoping she will push for IV antibiotics – do you think that is a good next step?