Courtesy of the American Heart Association

Warm weather is the ideal time to enjoy nature, but for those working in the garden or walking along wooded or grassy trails, it also means increased exposure to ticks, which spread Lyme disease. Lyme disease affects at least 30,000 people each year in the United States. Certain ticks carry the bacteria that cause the disease and are most common in the Northeast, parts of the Midwest, and some Pacific coast states.

Besides Lyme’s characteristic “bull’s-eye” rash, other symptoms may include fever, chills, headache, fatigue, muscle and joint aches, swollen lymph nodes, and a serious but rare heart condition called Lyme carditis. There are approximately one in 100 reported cases of Lyme Carditis each year. When bacteria from the infection reach the heart, it causes inflammation, which disrupts the electrical signals passing between the heart’s upper and lower chambers, leading to an irregular heartbeat known as heart block. Heart block can range from mild to severe and may cause chest pain, according to Dr. Richard Shen, an infectious disease specialist at Southcoast Health in Massachusetts. It can be challenging to detect and might resolve on its own, but if left untreated, in rare cases, it can be fatal. Lyme infections, if left untreated, can also spread to the nervous system.

Lyme carditis can cause symptoms such as lightheadedness, fainting, shortness of breath, heart palpitations, or chest pain. Diagnosis begins with a blood test to detect Lyme disease, followed by an electrocardiogram to identify Lyme carditis. Typical treatment involves a three-week course of oral or intravenous antibiotics, and sometimes a temporary pacemaker is also used. “The type of treatment depends on the severity of the symptoms,” says Dr. Kevin Shah, director of the cardiovascular intensive care unit at the University of Utah in Salt Lake City.

Shah says the best way to prevent Lyme carditis or Lyme disease is to avoid areas where ticks are common, noting that outdoor workers face a higher risk of exposure. Dogs are also susceptible to tick bites and can bring them into the house. Therefore, check them for ticks around the tail, ears, collar, between the legs, and on the toes after they have been outside. Consult your veterinarian about recommended tick prevention products.

To prevent tick bites in people, the Infectious Disease Society of America, the American Academy of Neurology, and the American College of Rheumatology recommend using insect repellents containing DEET, permethrin, or lemon eucalyptus oil. If a tick attaches to the skin, don’t try to burn it off or use chemicals or petroleum products to remove it. Instead, remove it carefully with clean, fine-tipped tweezers.

Finding a tick on your skin – even if it has already bitten you – doesn’t mean you’ll automatically get Lyme disease. The disease needs the tick to bite a person for a day or two before transmission happens, so check for ticks daily after being outside and remove them. “If you can do that before they stay on too long, you should be able to avoid Lyme disease pretty well,” says Dr. Shah.