Sudden Cardiac Deaths Linked to Lyme Carditis

[MeSci]

I don't want to be alarmist, but this was in Friday's Physician's First Watch:

Three Cases of Sudden Cardiac Death Linked to Lyme Carditis
By Cara Adler

Three cases of sudden cardiac death associated with Lyme carditis were reported in 2012 and 2013 and are described in MMWR. Only four such deaths have previously been reported.

The three patients, aged 26 to 38, lived in states with a high incidence of Lyme disease. None had rash; two had preexisting heart conditions. Postmortem investigation by state health departments and the CDC found Borrelia burgdorferi in heart tissue and evidence of Lyme carditis in all three patients.

"Physicians and health-care providers should ask patients with suspected Lyme disease about cardiac symptoms, and conversely, ask patients with acute, unexplained cardiac symptoms about possible tick exposure and symptoms of Lyme disease," the authors recommend.

Link(s):
MMWR article (Free) http://click.jwatch.org/cts/click?q=227;67931416;+zCwVdlwzgV+aWfeSTLj64cucfkduyAyVKb2caC3OcA=

 

[anciendaze]

Borreliosis (Lyme) is not the only such pathogen. There were episodes of sudden cardiac death among Swedish athletes competing in orienteering many years ago. Autopsies showed massive damage to the left ventricle of the heart, but it took a long time to discover bartonella bacteria in the tissue. This was also believe to be transmitted from wild animals via tick bites, since the victims were free of lice, and did not use IV drugs.

Another disease seen in childhood which causes similar damage is rheumatic fever, which involves streptococcus. Since this infection is not at all rare in humans, commonly causing pharingitis or strep throat, we still need to explain why it seldom results in massive heart damage. Some kind of immune impairment seems likely.