Learn About Your Heart...
Made Simple

By Nicolas Shammas, MD

A new, comprehensive sourcebook for
heart and vascular disease patients

Cardiovascular Health Topics

Statistics about Heart and Blood Vessel Diseases in the United States
Structure and Function of the Heart and Blood Vessels
Diseases of the Blood Vessels of the Heart
Surgical Therapies for the Cardiovascular Patient
Peripheral Vascular Disease
Diseases of the Blood Vessels of the Head and Neck
Strokes: How to Survive Them and How to Prevent Them
Valvular Heart Disease
Heart Rhythms: How to Recognize Them and Treat Them
Congestive Heart Failure
11. Understanding Cardiomyopathy, or Weak Heart Muscle
12. Children and Heart Disease
13. Diseases of the Pericardium
14. Systemic Illnesses, Infections and Drugs that Affect the Heart
15. Erectile Dysfunction: a Vascular Disease
16. Cardiovascular Disease Prevention
17. Heart Healthy Nutritional Tips
18. Cardiac Rehabilitation
19. Medications for Cardiovascular Disorders
20. Heart Tests You Need to Know
21. Learn What to Do in a Medical Emergency
22. How to Choose Your Doctor and Hospital
23. Medical Research and How You Can Get Involved
24. Taking the Next Step — A Few Community Resources to Help You Live More Healthfully
25. How Much Did You Learn from This Book: Take a Simple Test


Moutasim H. Al-Shaer, MD

Can Lyme disease affect the heart?

Lyme disease is an infection that affects multiple body systems caused by an organism called Borrelia burgdorferi. Ticks that exist in certain areas of the United States transmit the disease. This infection goes through 3 stages. In the first stage, people usually experience rash and flu-like symptoms. The second stage is when the disease affects the heart and other organs. The third stage is usually the arthritis stage.

During the second stage, 8% of the people affected experience heart involvement, which happens within the first 2 months of the infection. For some, this involvement is not apparent, but others may complain of lightheadedness, shortness of breath, fast heartbeat, chest pain, or passing out.

A variety of heart rhythm abnormalities occur, ranging from simple problems to those requiring a pacemaker.

The most common manifestation of the disease is infection of the heart muscle.This is usually temporary and presents as an enlargement of the heart due to fluids in the sac around the heart. This fluid might appear on a chest x-ray or an ultrasound of the heart. In some rare cases, these effects may last a long time.

Antibiotics are usually administered to treat this condition, although there is no strong evidence to support that this treatment facilitates the improvement of heart disease. These antibiotics are given either by mouth or through the veins (intravenous). Oral antibiotics are usually given in mild cases, whereas patients with symptoms of passing out or lightheadedness are usually admitted to the hospital, where they are monitored and given intravenous antibiotics.

With adequate treatment and monitoring, patients usually experience good outcomes. The rhythm problems usually resolve spontaneously within 2 to 3 months, although sometimes patients might need a pacemaker for a short period.

Can systemic lupus erythematosus (SLE) affect the heart?

Systemic lupus erythematosus (lupus) is an autoimmune disease (a disease where the immune system attacks the person's own organs). Most patients with lupus experience periods of increased and decreased disease activity. This disease affects multiple organs in the body, including the joints, heart, skin, kidneys, blood, and spleen.

Lupus affects the heart in almost 75% of patients. Usually, the heart valves are the most commonly affected parts of the heart. The pattern of involvement of the valves includes thickening, valve growths, or problems with leaking or narrowed valves.This involvement might worsen or resolve during the course of the disease and might lead to scarring of the heart valves.

The pericardium (sac of the heart) is the second most commonly affected part of the heart. The sac could either be inflamed and irritated (pericarditis) or filled with fluids (pericardial effusion). In addition, inflammation of the heart muscle (myocarditis) can occur.

Problems with the heart rhythm can occur but are usually mild. Increased heart rate has been shown to be an indicator of increased disease activity.

Patients with lupus have accelerated plaque buildup in their arteries (atherosclerosis). This might be caused by the increased presence of high blood pressure, cholesterol abnormalities, vessel injury from the autoimmune process, increased blood tendency to form clots, sedentary lifestyle caused by arthritis, or medications used to treat lupus.

Patients with lupus suffer from involvement of multiple organs and body systems, making heart complications a single part of the disease process. Usually, the affliction of the heart is not the major cause of sickness and death in these patients.

Can sarcoidosis affect the heart?

Sarcoidosis is a disease of unknown origin that affects multiple systems within the body. It usually affects young and middleaged individuals. The disease presents with cough, shortness of breath, night sweats, fatigue, and skin changes. Approximately 80% of individuals with the disease experience spontaneous disappearance of the disease within 2 years. Cardiac sarcoidosis (sarcoidosis affecting the heart) can be abenign or a life-threatening disorder.

Heart involvement may happen before, during, or after sarcoidosis affects the lungs. The most common effect on the heart is electrical disturbance (arrhythmia). This usually starts without symptoms but may progress and even require a pacemaker.

Rhythm problems occur in as many as a fifth of patients with sarcoidosis. These rhythm problems sometimes lead to sudden death in people with sarcoidosis. The mild forms of rhythm problems are usually evident on electrocardiogram early in the course of this disease.

Heart failure (weakening of the heart muscle) may occur when the muscle is invaded with granulomas (a group of cells that are caused by sarcoidosis). Sometimes granulomas invade the muscles that control heart valve motion. This may lead to leakage of the heart valves.

When the granulomas invade the heart muscle, an alteration in the appearance of the electrocardiogram results, and this might be mistaken for a heart attack.

Sarcoidosis commonly affects the lungs, leading to stiffness of the lungs and increased pressure inside them.This lung involvement can lead to excess pressure on the right side of the heart (Cor pulmonale).

The pericardium (the heart sac) rarely is affected by sarcoidosis, although it may become inflamed, giving rise to pericarditis (inflammation of the heart sac).

What is the effect of HIV infection on the heart?

Human immunodeficiency virus (HIV) is a germ (retrovirus) that infects the blood cells responsible for the body's defense against foreign organisms. Immunity against infections is reduced in patients with HIV. People with HIV have more serious infections than healthy people. With new advances in the treatment of HIV infection, people infected with this virus are living longer. Therefore, heart manifestations of this infection are more apparent.

HIV-infected people can have a variety of heart diseases. Pericarditis (inflammation of the heart sac) is the most frequent of these complications, and when it is associated with a pericardial effusion (fluid in the heart sac), it can become a serious complication.

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