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Can Lyme Disease Cause Congestive Heart Failure

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Enhancing Healthcare Team Outcomes

Myocarditis (Heart Inflammation) Signs & Symptoms (& Why They Occur)

Patients with Lyme disease, in general, are managed by an interprofessional team because of its diverse presentation and difficulty in diagnosis. The majority of cases are manageable by the primary caregiver, nurse practitioner, and internist as part of an interprofessional team. However, Lyme carditis is best managed by an infectious disease expert and a cardiologist. While the condition usually resolves, close monitoring is necessary as some patients may require temporary pacing.

Lyme disease is best prevented. Primary care clinicians and nurses should work together to provide patient and family education in endemic areas.

Even though Lyme carditis occurs in only a small percentage of patients with Lyme disease, significant consequences can develop. Thus, people going to or living in endemic areas require education regarding protective measurements. Hikers should wear appropriate garments and know how to remove the tick.

If symptoms develop, immediate medical evaluation and assistance is a prudent course of action. Medical providers must have a high clinical suspicion of the disease taking into account epidemiological risk factors. If the suspicious index is high, further serologic testing is necessary for confirmation. Prompt treatment is required in established cases as the resolution rate is high if actions take place with no delay.

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Pale Colored Nails Can Indicate Congestive Heart Failure

While shortness of breath and altered heart rate are the symptoms most commonly associated with congestive heart failure, theres a much lesser known symptom that may appear on your fingernails. This is known as Terrys nails, a symptom in which most of the nail appears to be a pale white color, and a band of pink is present at the tip of the nail, the area known as the distal band.

According to one study published in the Indian Journal of Dermatology, the color change in your nails is caused by reduced vascularity resulting from the hearts inability to pump blood effectively, as well as an overgrowth of connective tissue.

Heart Failure Treatments And Covid

The key to managing heart failure is adhering to a treatment strategy that includes medications and lifestyle changes. In severe cases, implants or surgeries may be required. Some common prescription medications used to treat heart failure include:

  • Angiotensin-converting enzyme inhibitors like Capoten , Zestril , Vaseretic , and Altace
  • Angiotensin receptor blockers like Diovan and Cozaar
  • Beta-blockers like Coreg , Toprol-XL , and Ziac
  • Neprilysin inhibitors like Entresto
  • Mineralcorticoid receptor antagonists like Aldactone
  • Vasodilators like BiDil
  • Antiarrhythmics like Lanoxin
  • I channel blockers like Corlanor
  • Diuretics like Lasix and Demadex

Many of these medications carry a risk of side effects like dizziness, low blood pressure, shortness of breath, and difficulty breathing. These symptoms can be exacerbated by COVID-19 or make a coronavirus infection feel worse.

People with heart failure should stick to the medication regimen prescribed by their healthcare providerâeven if they have COVID-19. Call your practitioner before making any medication changes on your own.

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Early Localized Lyme Disease

In the majority of cases, the first sign of Lyme disease is the appearance of a bull’s-eye rash called erythema migrans , which surrounds the site of the bite. It usually develops about 1 to 2 weeks after the bite, but can appear as soon as 3 days or as late as 1 month after. In some cases, it is never detected. The rash is often accompanied by flu-like symptoms such as fever, headache, fatigue, neck pain and stiffness, and body aches.

The bull’s-eye skin rash is considered a classic sign of Lyme disease. It usually appears on the thigh, buttock, or trunk in older children and adults, and on the head or neck in younger children.

The bull’s-eye rash may take the following course:

  • It can first appear as a pimple-like spot that expands over the next few days into a purplish circle. The circle may reach up to 6 inches in diameter with a deeper red rim. In some cases the ring is incomplete, forming an arc rather than a full circle.
  • The center of the rash often clears or may turn bluish. Or secondary concentric rings may develop within the original ring, creating the bull’s-eye pattern. Over the next several days or 1 to 2 weeks, the circular rash may grow to as large as 20 inches across
  • The rash has a burning sensation. On darker-skinned people, the rash may resemble a bruise. In most people, the rash fades completely after 3 to 4 weeks. Secondary rashes may appear during the later stages of disease.

How Can Coffee Affect Your Health

Can Lyme Disease Cause Congestive Heart Failure

There are two different types of risks associated with coffee: acute and chronic risks.

Acute risk includes having a heart attack, arrhythmia or indigestion, with or without ulcers after you consume too much caffeine.

These symptoms require immediate medical attention. The chronic risk is developing heart diseases due to your overall health. Given that caffeine increases your metabolism,

it can cause elevated blood pressure and increase cholesterol levels in the body as well as increase the demands on your kidneys and adrenal glands.

Such conditions can lead to heart attacks and arrhythmias if neglected over a long period of time.

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Acute Heart Failure From Lyme Carditis

Ryan KoeneDavid R. BoulwareMelissa KempermanSuma H. KonetyMorgan GrothJose JessurunPeter M. Eckman

Carditis can complicate Lyme disease in an estimated < 5% of cases, but cardiogenic shock is rare. We report a case of severe biventricular heart failure as a manifestation of a Jarisch-Herxheimer reaction in a patient with early Lyme disease following treatment with ceftriaxone.

Case Report

Figure 1.A, ECG at admission showing complete heart block. B, Telemetry demonstrating regression from third-degree atrioventricular block to polymorphic ventricular tachycardia as the patient began reporting presyncopal symptoms. C, During the first 5 hospital days, the patient had several transformations into polymorphic VT that required pacing. This rhythm strip demonstrates ventricular flutter that occurred on hospital day 3.

Figure 3. Treatment time course in relation to serum C-reactive protein: 10% , 45% , and 61% .

What Are The Stages Of Congestive Heart Failure

Based on the symptoms and the amount of effort required to provoke them, the New York Heart Association has divided degrees of heart failure into four classes:

  • Class I: Patients have no limitation of physical activity.
  • Class II: Patients have a slight limitation of physical activity.
  • Class III: Patients have marked limitations of physical activity.
  • Class IV: Patients have symptoms even at rest and are unable to carry on any physical activity without discomfort.

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Myth : Deep Brain Stimulation Is Experimental Therapy

Fact: Deep brain stimulation, or DBS, is a procedure in which doctors place electrodes in the brain at the point when medications are less effective in masking motor symptoms, such as tremor, stiffness and slowness of movement.

While it may sound frightening and futuristic, its been around and successfully used for decades. DBS works very similarly to a pacemaker, except the wire is in the brain, not in the heart. Its been a standard procedure for the past two decades.

Heart Failure And Covid

Myocarditis- Cardiac Pathology

People with a pre-existing heart problem like heart failure are about 10% to 20% more likely to experience severe illness from COVID-19 compared to people with healthy hearts. They are also more likely to get much sicker and even die because of COVID-19.

Nearly 1 in 3 adults with a history of heart failure died during hospitalization for COVID-19. This is almost double the in-hospital mortality for adults without heart failure.

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What Is Lyme Carditis

Lyme carditis occurs when Lyme disease bacteria enter the tissues of the heart. This can interfere with the normal movement of electrical signals from the hearts upper to lower chambers, a process that coordinates the beating of the heart. The result is something physicians call heart block, which can vary in degree and change rapidly. Lyme carditis occurs in approximately one out of every hundred Lyme disease cases reported to CDC.

When Lyme Hurts Your Heart: Warning Signs + Solutions

Ryan Stewart, a speech-language pathologist in Virginia, developed a strange set of symptoms in 2009 that baffled one doctor after another. Included among those symptoms were a racing heartbeat following minimal physical exertion, heart palpitations, shortness of breath, and chest pain. It felt like an elephant was sitting on my chest, she explains.

Over the next 10 years, Stewarts symptoms waxed and waned. Some days, they would let up other days, a sudden episode of rapid heartbeats or dizziness would frighten her sending her to the emergency room or an urgent care clinic.

Unfortunately, she always left those healthcare facilities without answers. Though Stewart believed her symptoms stemmed from her heart, repeated electrocardiograms , a cardiac MRI, and a couple week-long stints of wearing heart monitors all came back as normal. They could never catch a cardiac episode, she says.

Determined to live a normal life, Stewart continued her work as an SLP and began planning a family with her husband. After a series of fertility treatments, she became pregnant only to suffer a miscarriage in the early weeks a devastating loss, she says.

I knew this was a new symptom, and I had to go to the ER, says Stewart. They discovered I had ventricular tachycardia, and gave me a diagnosis of idiopathic ventricular tachycardia. Idiopathic meaning they didnt know what the cause was.

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Polymerase Chain Reaction Test

The polymerase chain reaction test detects the DNA of the bacteria that causes Lyme disease. It is sometimes used for select individuals who have neurological symptoms or Lyme arthritis. The PCR test is performed on spinal fluid collected from a lumbar puncture or synovial fluid . This test is generally available only in research settings and for most people, standard 2-step tests are preferred.

Early Disseminated Lyme Disease

Can Lyme Disease Cause Congestive Heart Failure

If left untreated, the infection can spread through the bloodstream and lymphatic vessels within weeks to months where it may affect the joints, nervous system, heart, or other organs. Symptoms of early disseminated Lyme disease include:

  • Multiple bull’s eye rashes on various parts of the body.
  • Weakness or paralysis in the muscles of the face
  • Stiff and painful neck, which may be a sign of Lyme meningitis
  • Heart problems symptoms include light-headedness, heart palpitations, shortness of breath, chest pain, or fainting

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Ways To Prevent Anemia And Heart Failure

Anemia caused by an iron, B12, or B9 deficiency can be prevented by eating more foods rich in those vitamins and minerals. In addition, vitamin C helps your body better absorb those vitamins. However, anemia that is inherited can’t be prevented.

You can prevent heart failure by avoiding heart disease. Some risk factors for heart disease are unavoidable. These include older age, sex, race/ethnicity, and family history. Health conditions, like diabetes, can also put you at higher risk for heart disease.

Some ways to lower your risk for heart disease include:

  • Controlling your blood pressure
  • Not drinking too much alcohol

What Is The Association Between Anemia And Heart Failure

When heart failure happens, fluid gets trapped in the lungs. Fluid also gets backed up in the feet and legs, causing swelling, or edema.

Because your heart cant pump enough blood around your body, your organs dont get enough oxygen. As a result, one complication of heart failure is chronic kidney disease . In this condition, the blood vessels in the kidneys are damaged. The kidneys cant get enough oxygen, making it difficult for them to filter blood.

CKD also lowers the amount of erythropoietin the kidneys make. EPO is a type of protein that helps make red blood cells. Low levels of EPO can cause anemia.

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Blood Tests For Antibodies

Blood tests for detecting antibodies to B. burgdorferi are most reliable several weeks after infection has occurred and are rarely of value during the first 7 to 10 days of illness. During these initial days of infection, these tests can give false negative results .

Most authorities, including the CDC, recommend a 2-step testing process for Lyme disease:

  • EIA Test. The first test used is an enzyme immunoassay . The EIA measures IgM and IgG antibodies to the B. burgdorferi spirochete. Positive results from this test still require confirmation with a Western blot test, since the EIA test is often positive even when there has been no infection. Negative results do not require further testing.
  • Western Blot or second EIA test. If the EIA test is positive or uncertain, it is followed by the Western blot test. This test is more accurate and is very helpful in confirming the diagnosis but is more expensive and takes longer to complete. The Western blot creates a visual graph showing bands of IgM or IgG antibodies that laboratories use to interpret the immune response. More recently, recommendations have changed to allow for a second EIA in place of the confirmatory Western blot .
  • V1sE . This newer FDA-approved test detects a specific component within the EIA IgG antibodies and is being increasingly used instead of the Western Blot to confirm a positive EIA test. Since it is less expensive and more rapidly completed, it may ultimately replace the Western Blot test.

I Ended Up In The Cardiac Icu It Was A Rare Complication Of Lyme Disease

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Eric Miller, 43, teaches principles of design and fabrication, maker classes and programming at a boarding school in Northeastern Ohio. As he started his new position last summer, he experienced a health crisis and landed him in the cardiac ICU with a dangerous arrhythmia. Doctors soon learned that he had Lyme carditis, a rare complication of Lyme disease. He shared his story with TODAY.

During employee orientation for my new job, I started feeling really rundown in the evenings. At first, I dismissed it as stress and nerves from starting a new career. When it became persistent, I thought I should make an appointment with a doctor for a checkup. But before I could, I became much sicker.

As soon as they saw the results, they brought in a crash cart to try to jolt my heart back into a normal rhythm before arranging a transfer to a Cleveland Clinic hospital. My health was so dire that I needed to be in a cardiac intensive care unit. As doctors continued running tests, they asked me about my medical history and thats when our recent trip to the Finger Lakes region in New York was mentioned. Almost immediately someone suggested Lyme disease.

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When Lyme Disease Enters The Picture

Like many other Lyme experts and patients, Dr. Bill Rawls, Medical Director of Vital Plan, believes many more than one in 10 people with Lyme disease may have some degree of heart issues. The symptomatology can vary from person to person, and exist on a spectrum of mild to severe.

The likely bacterial and viral culprits causing cardiovascular symptoms include Borrelia , Bartonella, Mycoplasma, cytomegalovirus , and probably many others. These stealth microbes enter the body and spread throughout the tissues by various mechanisms. They have one goal: Survival, notes Dr. Rawls. And they migrate or set up camp anywhere they can in the body, including the heart.

Theres a growing body of evidence showing that we have microbes throughout our body and brain, including on heart valves, says Dr. Rawls. Often, I think these microbes are present without causing harm. They stay dormant in tissues until a disruption in the immune system occurs and depresses it, allowing the microbes to flourish.

When stealth pathogens thrive, they can alter the electrical signaling to the heart, affecting the heartbeat or causing irritation to the heart itself.

Additionally, an abnormal heart rate isnt the only way microbes can affect the heart. As the pathogens disseminate throughout the organ and further irritate the heart muscle, the heart can become oxygen-deprived, leading to angina , heart attack, shortness of breath, and more.

Clinical And Ecg Evaluation

Each patient underwent an extensive evaluation including Hoehn & Yahr stage , Unified Parkinsons Disease Rating Scale , and Scale for Outcomes in PD for autonomic symptoms . Medications and comorbidities were recorded, using the Cumulative Illness Rating Scale . Levodopa Equivalent Daily Dose was also calculated. A long term time domain analysis of heart rate variability using 24-h 12-lead ECG recording , encompassing morning and night hours was performed and evaluated according to the NASPE/ESC Task Force in PD patients and age-matched healthy individuals. Both groups were asked to perform normal daily activity excluding intense physical activity. All time domain parameters analysed have been summarized in Table and calculated using cardioscan II software .

Table 1 HRV Time domain parameters evaluated in PD patients and controls

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Treating Late Stage Lyme Disease

Most cases of Lyme disease involve a rash and flu-like symptoms that resolve within 1 month of antibiotic treatment. However, some people go on to develop late-stage Lyme disease, which includes Lyme arthritis and neurologic Lyme disease.

Untreated, slightly more than half of people infected with B. burgdorferi will develop Lyme arthritis. About 10% to 20 % of people develop neurologic Lyme disease. A very small percentage may develop acrodermatitis chronica atrophicans, a serious type of skin inflammation occurring more frequently in Europe. These conditions are treated for up to 28 days with antibiotic therapy.

If arthritis symptoms persist for several months, a second 2 to 4 week course of antibiotics may be recommended. Oral antibiotics are used for Lyme arthritis and acrodermatitis chronica atrophicans.

In rare cases, people with arthritis may need intravenous antibiotics. A 2 to 4 week course of intravenous ceftriaxone is used for treating severe cases of neurological Lyme disease. For milder cases, 2 to 4 weeks of oral doxycycline is an effective option.

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