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Diagnosis and management of myocarditis in athletes
Fred H Brennan1, Benjamin Stenzler, Ralph Oriscello
1Primary Care Sports Medicine, Dewitt Army Community Hospital, 2740 Prosperity Avenue, Fairfax, VA 22030, USA. fredb87@hotmail.com
Insights
Myocarditis, an inflammation of the heart muscle, poses risks for athletes. Recovery requires 6 months of activity abstinence and normal cardiac function before returning to sports.
Area of Science:
- Cardiology
- Sports Medicine
- Infectious Diseases
Background:
- Myocarditis, characterized by myocardial inflammation and necrosis, presents significant risks for competitive athletes.
- Cardiotropic viruses, notably Coxsackie B virus, are identified as the primary cause of acute myocarditis in the US.
Observation:
- Diagnosis involves a comprehensive evaluation including patient history, physical exam, electrocardiogram, echocardiogram, cardiac enzymes, and sedimentation rate.
- Athletes diagnosed with acute myocarditis require a minimum 6-month period of abstaining from moderate to vigorous physical activity.
Findings:
- Successful recovery is contingent upon the normalization of cardiac function and the absence of any demonstrable arrhythmias.
- These criteria are essential for the safe return of athletes to competitive sports.
Implications:
- Understanding myocarditis etiology and diagnostic markers is crucial for timely intervention in athletes.
- Establishing clear return-to-sport guidelines post-myocarditis is vital for preventing adverse cardiac events and ensuring athlete safety.
Abstract:
Myocarditis is a pathologic entity that has serious potential consequences for competitive athletes. Myocarditis is an inflammation of the myocardium accompanied by myocellular necrosis. Cardiotropic viruses, in particular the Coxsackie B virus, have been implicated as the most common cause of acute myocarditis in the United States. A thorough history, physical examination, electrocardiogram, echocardiogram, elevated cardiac enzymes, and an elevated sedimentation rate help make the diagnosis. Athletes recovering from acute myocarditis should abstain from moderate to vigorous activity for 6 months, have normal cardiac function, and have no demonstrable arrhythmia before returning to sports.