Key result
Review recommends temporary sports abstinence and individualized risk stratification for athletes post-myocarditis or COVID-19.
Why the study?
Myocarditis remains a leading cause of sudden cardiac death in athletes, but accurate diagnosis is challenging and patients face risks of arrhythmias or dilated cardiomyopathy.
This review provides comprehensive clinical guidance on the diagnosis, risk stratification, and return-to-play protocols for athletes with myocarditis, with specific considerations for COVID-19.
Supports cautious return-to-play protocols with risk stratification in athletes post-myocarditis or COVID-19; leaves open prospective validation of recommendations.
Myocarditis is an umbrella term for non-ischemic myocardial inflammation and remains a leading cause of sudden cardiac death in active individuals and athletes. Accurate diagnosing is challenging and diseases could often remain undetected. In the majority of cases, acute myocarditis resolves favourably. However, a relevant proportion of patients may have an increased risk of prognostically relevant cardiac arrhythmias and/or the development and progression of maladaptive myocardial remodelling (dilated cardiomyopathy). This review provides current knowledge on myocarditis and sports with special regard to the COVID-19 pandemic. Possible causes, common symptoms and proposed diagnostics are summarized. The relevance of temporary avoidance of intensive sports activities for both the prevention and therapy of acute myocarditis is discussed. Risk stratification, specific return-to-play recommendations and proposed follow-up diagnostics (also after COVID-19 infection) are presented.
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Schmidt et al. (2022) conducted a review in Myocarditis and COVID-19. Return-to-play strategies was evaluated. Temporary abstinence from intensive sports and individualized risk stratification are recommended for athletes returning to play after myocarditis or COVID-19 infection.
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