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Return-to-Play Post-Myocarditis for Athletes: To Play or Not to Play?
Kentaro Yamagata1, Aneil Malhotra1
1Institute of Sport, Manchester Metropolitan University, Manchester M1 7EL, UK.
Diagnostics (Basel, Switzerland)
|October 16, 2024
Summary
Athletes with myocarditis face risks like sudden cardiac death. This review proposes a return-to-play algorithm using cardiac MRI, emphasizing shared decision-making for athlete recovery and safety.
Area of Science:
- Cardiology
- Sports Medicine
- Inflammatory Diseases
Background:
- Myocarditis, heart muscle inflammation, poses risks including sudden cardiac death and arrhythmias.
- Athletes, particularly those in high-intensity training, have increased myocarditis risk due to factors like reduced immunity.
Purpose of the Study:
- To review clinical presentation, guidelines, and diagnostic challenges of myocarditis in athletes.
- To highlight the role of cardiac magnetic resonance imaging (CMR) in detecting myocardial inflammation and scarring.
- To propose an algorithm for return-to-play (RTP) decisions in athletes post-myocarditis.
Main Methods:
- Review of current literature on myocarditis in athletes.
- Analysis of diagnostic challenges and the significance of CMR, including late gadolinium enhancement (LGE).
- Development of a proposed RTP algorithm incorporating CMR findings and shared decision-making.
Main Results:
- Current guidelines recommend exercise restriction and reassessment for RTP.
- Knowledge gaps exist regarding persistent LGE on CMR and optimal exercise restriction duration.
- The psychological impact of myocarditis on athletes necessitates mental health support.
Conclusions:
- A shared decision-making approach is crucial for RTP, balancing athlete health and risks.
- The proposed CMR-integrated RTP algorithm aims to improve risk stratification.
- Further longitudinal research is needed to refine RTP protocols and understand athlete recovery outcomes.
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