Why the study?
Does cardiac magnetic resonance (CMR) improve detection of myocarditis in symptomatic post-COVID-19 athletes compared to standard cardiac tests?
Does cardiac magnetic resonance (CMR) improve detection of myocarditis in symptomatic post-COVID-19 athletes compared to standard cardiac tests?
CMR can detect SARS-CoV-2 myocarditis in symptomatic athletes even when standard screening tests like echocardiography and troponin are normal.
Standard AHA tests may miss myocarditis after mild COVID-19; leaves open CMR in symptomatic athletes and should not yet change practice.
This case report describes a high school athlete with palpitation, myalgia, fatigue, and dyspnea on exertion after SARS-CoV-2 infection with evidence of myocarditis by cardiac magnetic resonance (CMR), but echocardiography and troponin were normal. This case is unusual as the standard cardiac tests recommended by the American Heart Association for sports clearance, including ECG, echocardiography, and cardiac biomarkers, were normal. Still, she continued to be symptomatic after mild COVID-19. The CMR was performed to evaluate her unexplained palpitation and showed patchy myocardial edema two months after her initial SARS-CoV-2 infection. In this case, the diagnosis of myocardial involvement would be missed by normal echocardiograms and cardiac bio-markers without CMR. Because acute myocarditis is a risk factor for sudden death in competitive athletes, pediatric cardiologists should consider performing additional tests such as cardiac MRI in symptomatic COVID-19 patients, even if cardiac biomarkers and echocardiograms are normal.
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Bibhuti B. Das (2021) studied this question.
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