Three deaths associated with Lyme carditis

Hello, and welcome to another Inside Lyme Podcast. I am your host Dr. Daniel Cameron. In this podcast, I will be discussing three deaths associated with Lyme carditis.

Three deaths associated with Lyme carditis

I first read about these cases in the Morbidity and Mortality Weekly Report (MMWR) published by the Centers for Disease Control and Prevention (CDC).

The authors described three deaths associated with Lyme disease. All three were diagnosed with Lyme carditis on autopsy.

Patient 1

“In November 2012, a Massachusetts resident was found unresponsive in an automobile after it veered off the road,” wrote the authors.  He had no cardiac activity by the emergency responders. He was pronounced dead at a nearby hospital.

We know very little about the patient. “Interviews with next-of-kin revealed that the patient had described a nonspecific illness with malaise and muscle and joint pain during the 2 weeks preceding death,” wrote the authors. The authors added, “The patient lived alone with a dog that was reported to have ticks frequently.”

He was diagnosed with Lyme carditis on autopsy.

Patient 2

“In July 2013, a New York state resident experienced chest pain and collapsed at home,” wrote the authors. The patient was pronounced dead after failing cardiopulmonary resuscitation.  The patient had a history of Wolff-Parkinson-White syndrome (WPW).  In WPW is condition characterized by abnormal electrical pathways that can causes a rapid heartbeat.  There was no history of a tick bite or a rash.

The patient was also diagnosed with Lyme carditis on autopsy.

Patient 3

“In July 2013, a Connecticut resident collapsed while visiting New Hampshire and was pronounced dead at a local hospital,” wrote the authors.

“The patient had complained of episodic shortness of breath and anxiety during the 7–10 days before death,” wrote the authors.  He was prescribed the anti-anxiety medication clonazepam the day prior to death.  There was no EKG performed.

The patient was diagnosed with Lyme carditis.

All three of these individuals tested positive for Lyme disease on autopsy.

What questions do these cases raise?

1. What is Lyme carditis?
2. How often does Lyme carditis occur?
3. How is Lyme disease diagnosed?
4. Can Lyme carditis be prevented?
5. How often are autopsies performed on patients with sudden death?
6. Why is the second patient’s history of Wolff-Parkinson-White syndrome (WPW) important?
7. How reliable are tests for Lyme disease in patients with sudden death?
8. Could the third patient still be alive if he had an EKG 7 to 10 days earlier when he presented with episodic shortness of breath and anxiety?
9. What is the significance of the dog in the first case?
10. What would you recommend?

Thanks for listening to another Inside Lyme Podcast. You can read more about these cases in my show notes and on my website @DanielCameronMD.com. As always, it is your likes, comments, reviews, and shares that help spread the word about Lyme disease. Until next time on Inside Lyme.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.